As such, the insulin/IGF pathway dysfunctions are linked to cortical atrophy, loss of synaptic plasticity, white matter myelin/oligodendrocyte degeneration, astrocyte and microglia neuroinflammation and oxidative stress, deficits in energy metabolism, mitochondrial dysfunction, and microvascular disease [28, 29]. The gene discussed is IGF1; the disease is Cerebral cortical atrophy.