Differences in amyloid fibril molecular structure might have a big impact on disease characteristics in Alzheimer’s disease, as Robert Tycko, PhD, of the National Institutes of Health, Bethesda, MD, explained at the Alzheimer’s Association International Conference (AAIC) 2018, held in Chicago, IL. Here, he describes his study investigating structural differences in Aβ40 and Aβ42 across typical Alzheimer’s patients, posterior cortical atrophy (PCA) patients and rapidly progressing Alzheimer’s patients. He discusses how amyloid structure in these peptides only appears to be different in rapidly progressing Alzheimer’s patients, who have much more structural heterogeneity in their samples. Finally, Dr Tycko speaks about the two predominant structures of Aβ42, and the insight that might be gained from researching them further.