Neuroinflammation and associated neuronal dysfunction mediated by activated microglia play an important role in the pathogenesis of Alzheimer disease (AD). Microglia are activated by aggregated forms of amyloid- protein (A), usually demonstrated in vitro by stimulating microglia with micromolar concentrations of fibrillar A, a major component of amyloid plaques in AD brains. Here we report that amyloid- oligomer (AO), at 5-50 nM, induces a unique pattern of microglia activation that requires the activity of the scavenger receptor A and the Ca 2؉ -activated potassium channel KCa3.1. AO treatment induced an activated morphological and biochemical profile of microglia, including activation of p38 MAPK and nuclear factor B. Interestingly, although increasing nitric oxide (NO) production, AO did not increase several proinflammatory mediators commonly induced by lipopolyliposacharides or fibrillar A, suggesting that AO stimulates both common and divergent pathways of microglia activation. AO at low nanomolar concentrations, although not neurotoxic, induced indirect, microglia-mediated damage to neurons in dissociated cultures and in organotypic hippocampal slices. The indirect neurotoxicity was prevented by (i) doxycycline, an inhibitor of microglia activation; (ii) TRAM-34, a selective KCa3.1 blocker; and (iii) two inhibitors of inducible NO synthase, indicating that KCa3.1 activity and excessive NO release are required for AO-induced microglial neurotoxicity. Our results suggest that AO, generally considered a neurotoxin, may more potently cause neuronal damage indirectly by activating microglia in AD.A, 2 a hydrophobic protein derived from proteolytic processing of the amyloid- precursor protein, self-aggregates into amyloid fibrils and deposits as amyloid plaques, one of the pathological hallmarks of AD. A aggregates, especially those of the 42-residue A42, are potent toxins to neurons. In addition, A aggregates activate microglia, which clear A, but in the process release inflammatory mediators that cause indirect neurotoxicity (1). A commonly held view is that microglia react to fA deposited in amyloid plaques, which form a nidus for microglia-mediated neuronal damage. However, because the number of amyloid plaques correlates poorly with the degree of dementia (2, 3), it follows that plaque-associated microglia may not be a major player in cognitive impairment. Emerging evidence including two recent in vivo positron emission tomography studies indicates that microglia may respond to stimuli other than plaque fA (4, 5), suggesting that alternative ways to activate microglia must occur in AD.In addition to fibrillar forms, A exists in various smaller assemblies in AD brains, which may mediate diverse toxic effects at different stages of the disease. Although these smaller aggregates, variously named as oligomers (AO), protofibrils, amyloid pores, or AD diffusible ligands, have been considered transient or metastable intermediates in fibril formation (6), some of them may not be obligate inter...