The Parkinson's disease (PD) substantia nigra is characterized by the presence of Lewy bodies containing fibrillar ␣-synuclein. Earlyonset PD has been linked to two point mutations in the gene that encodes ␣-synuclein, suggesting that disease may arise from accelerated fibrillization. However, the identity of the pathogenic species and its relationship to the ␣-synuclein fibril has not been elucidated. In this in vitro study, the rates of disappearance of monomeric ␣-synuclein and appearance of fibrillar ␣-synuclein were compared for the wild-type (WT) and two mutant proteins, as well as equimolar mixtures that may model the heterozygous PD patients. Whereas one of the mutant proteins (A53T) and an equimolar mixture of A53T and WT fibrillized more rapidly than WT ␣-synuclein, the other (A30P) and the corresponding equimolar mixture with WT fibrillized more slowly. However, under conditions that ultimately produced fibrils, the A30P monomer was consumed at a comparable rate or slightly more rapidly than the WT monomer, whereas A53T was consumed even more rapidly. The difference between these trends suggested the existence of nonfibrillar ␣-synuclein oligomers, some of which were separated from fibrillar and monomeric ␣-synuclein by sedimentation followed by gel-filtration chromatography. Spheres (range of heights: 2-6 nm), chains of spheres (protofibrils), and rings resembling circularized protofibrils (height: ca. 4 nm) were distinguished from fibrils (height: ca. 8 nm) by atomic force microscopy. Importantly, drug candidates that inhibit ␣-synuclein fibrillization but do not block its oligomerization could mimic the A30P mutation and thus may accelerate disease progression.amyloid ͉ aggregation ͉ protofibril ͉ atomic force microscopy (AFM) P arkinson's disease (PD) is an age-related neurodegenerative disorder characterized by difficulty in initiating movements, rigidity, and resting tremor (1). In PD, neuronal death is localized to dopaminergic neurons in the substantia nigra region of the brain stem and precedes appearance of symptoms; ca. 70% of neurons may have died by the time symptoms become apparent (1). The postmortem PD substantia nigra is characterized by sporadic intraneuronal cytoplasmic inclusions known as Lewy bodies (LB), the fibrous portion of which contains the protein ␣-synuclein (2, 3). Lewy bodies themselves could be neurotoxic, analogous to the proposed toxicity of amyloid plaques in Alzheimer's disease (AD) (4); the frequency of cortical Lewy bodies correlates with the severity of the AD-like dementia diffuse Lewy body disease (5). Alternatively, Lewy bodies may be an epiphenomenon, induced by neuronal death. Finally, it is possible that Lewy bodies are an inert end point of a process that, early on, produces a neurotoxic species. This scenario would predict that Lewy body formation may protect against neuronal death by sequestering the toxic species. Two neuropathological observations may be relevant to this issue.First, inclusion-bearing neurons appear to be more healthy than neighboring ...