Wild-type, full-length (40-and 42-residue) amyloid β-peptide (Aβ) fibrils have been shown by a variety of magnetic resonance techniques to contain cross-β structures in which the β-sheets have an in-register parallel supramolecular organization. In contrast, recent studies of fibrils formed in vitro by the Asp23-to-Asn mutant of 40-residue Aβ (D23N-Aβ 1-40 ), which is associated with early onset neurodegeneration, indicate that D23N-Aβ 1-40 fibrils can contain either parallel or antiparallel β-sheets. We report a protocol for producing structurally pure antiparallel D23N-Aβ 1-40 fibril samples and a series of solid state nuclear magnetic resonance and electron microscopy measurements that lead to a specific model for the antiparallel D23N-Aβ 1-40 fibril structure. This model reveals how both parallel and antiparallel cross-β structures can be constructed from similar peptide monomer conformations and stabilized by similar sets of interactions, primarily hydrophobic in nature. We find that antiparallel D23N-Aβ 1-40 fibrils are thermodynamically metastable with respect to conversion to parallel structures, propagate less efficiently than parallel fibrils in seeded fibril growth, and therefore must nucleate more efficiently than parallel fibrils in order to be observable. Experiments in neuronal cell cultures indicate that both antiparallel and parallel D23N-Aβ 1-40 fibrils are cytotoxic. Thus, our antiparallel D23N-Aβ 1-40 fibril model represents a specific "toxic intermediate" in the aggregation process of a disease-associated Aβ mutant.Alzheimer's disease | amyloid structure | solid state NMR A lzheimer's disease (AD) is thought to be a consequence of aggregation of the amyloid β-peptide (Aβ) into amyloid fibrils or related assemblies in brain tissue. Numerous structural studies of Aβ fibrils and oligomers have been reported (1-17), motivated by the dual goals of contributing to preventive and therapeutic approaches to AD and of elucidating the biophysical basis for amyloid formation. A defining structural characteristic of an amyloid fibril is the presence of a cross-β motif; i.e., a ribbon-like β-sheet running the length of the fibril, with β-strands approximately perpendicular to and interstrand hydrogen bonds approximately parallel to the long fibril axis. Studies of the 40-residue and 42-residue forms of Aβ (Aβ 1-40 and Aβ 1-42 ) have shown that these peptides can form multiple distinct fibril structures (11,18,19), but that the cross-β motifs within wild-type (WT) Aβ fibrils are invariably comprised of in-register parallel β-sheets (1, 5, 6, 8-10, 13, 14). Parallel β-sheets have also been found in Aβ 1-40 oligomers (4) and in amyloid fibrils formed by amylin (20, 21), α-synuclein (22), β 2 -microglobulin (23, 24), prion proteins of yeast (25-27) and mammalian PrP (28, 29); in contrast, antiparallel β-sheets have been found in fibrils formed by Aβ fragments with 15 or fewer residues (30-32) and in amyloid-like crystals of certain Aβ fragments (33). These observations suggest that in-register parallel β-shee...