To identify a lead skeleton structure for optimization of scyllo-inositol-based inhibitors of amyloid-beta peptide (Aβ) aggregation, we have synthesized aldoxime, hydroxamate, carbamate, and amide linked scyllo-inositol derivatives. These structures represent backbones that can be readily expanded into a wide array of derivatives. They also provide conservative modifications of the scyllo-inositol backbone, as they maintain the display of the equatorial polar atoms, preserving the stereochemical requirement necessary for maximum inhibition of Aβ(1-42) fiber formation. In addition, a reliable work plan for screening derivatives was developed in order to preferentially identify a backbone(s) structure that prevents fibrillogenesis and stabilizes nontoxic small molecular weight oligomers, as we have previously reported for scyllo-inositol. In the present studies, we have adapted a high throughput ELISA-based oligomerization assay followed by atomic force microscopy to validate the results screen compounds. The lead compounds were then tested for toxicity and ability to rescue Aβ(1-42) induced toxicity in vitro and the affinity of the compounds for Aβ(1-42) compared by mass spectrometry. The data to suggest that compounds must maintain a planar conformation to exhibit activity similar to scyllo-inositol and that the oxime derivative represents the lead backbone for future development. KEYWORDS: Amyloid-beta peptide, fibrillogenesis, medicinal chemistry, atomic force microscopy, mass spectrometry scyllo-Inositol, a potential therapeutic compound for Alzheimer's disease, has been shown to inhibit Aβ(1-42) fibrillogenesis in vitro, 1 stabilize cell-derived small molecular weight oligomers, 2 reduce amyloid plaque load and neuroinflammation, and ameliorate cognitive deficits in vivo. 2,3 These combined studies demonstrated that scyllo-inositol stabilizes low molecular weight oligomers of Aβ that are nontoxic and readily removed from and/or degraded within the central nervous system. scyllo-Inositol is the most potent inositol, with a single epimerization to form myo-inositol yielding a less active compound in vivo and in vitro, suggesting that efficacy is highly dependent on inhibitor stereochemistry. 3 scyllo-Inositolinduced changes to the peptide assembly of Aβ(1-42) are very sensitive to structural perturbations of scyllo-inositol such as the number and orientation of the hydroxyl groups. 2 These structure− function studies revealed that even the most conservative single hydroxyl substitution led to a decrease in compound potency with only 1-deoxy-1-fluoro-scyllo-inositol retaining properties similar to the parent scyllo-inositol. 4