Accumulation of the -amyloid protein (A) in the brain is an important step in the pathogenesis of Alzheimer's disease. However, the mechanism of A toxicity remains unclear. A can bind to the extracellular matrix, a structure that regulates adhesive events such as neurite outgrowth and synaptogenesis. The binding of A to the extracellular matrix suggests that A may disrupt cell-substrate interactions. Therefore, the effect of substrate-bound A on the growth of isolated chick sympathetic and mouse cortical neurons was examined. A1-40 and A1-42 had dose-dependent effects on cell morphology. When tissue culture plates were coated with 0.1-10 ng/well A, neurite outgrowth increased. Higher amounts of A peptides (Ն3 g/well) inhibited outgrowth. The inhibitory effect was related to aggregation of the peptide, as preincubation of A1-40 for 24 h at 37°C (a process known to increase amyloid fibril formation) was necessary for inhibition of neurite outgrowth. A29 -42, but not A1-28, also inhibited neurite outgrowth at high concentrations, demonstrating that the inhibitory domain is located within the hydrophobic C-terminal region. A1-40, A1-42, and A29 -42 also inhibited cell-substrate adhesion, indicating that the effect on neurite outgrowth may have been due to inhibition of cell adhesion. The results suggest that accumulation of A may disrupt celladhesion mechanisms in vivo.