miR-186-5p, also identified in our study, impacts the NLRP3/IGF1 pathway in an in vitro TBI model.43 Exosomal miR-223-3p is increased in participants with small-vessel cerebrovascular disease-associated cognitive impairment compared with those with cerebrovascular disease alone or normal controls.44 Given that TBI is a known risk factor for late-life cognitive decline,23,45,46 investigating the role of miR-223-3p in response to TBI and small-vessel cerebrovascular disease may yield mechanistic targets for future therapies designed to mitigate these sequelae. This evidence concerns the gene IGF1 and Cognitive impairment.