The atomic models of ALS were constructed de novo, and IGF1/IGFBP3 models were manually built after fitting the crystal structure of the IGF1/IGFBP4 complex (NBP4 and CBP4 fragment without CLD; PDB: 2DSR)12 on the cryo-EM map. Here, IGFBP3 is linked to amyotrophic lateral sclerosis.