Why there was no significant change in NfL over 3 years in SCANS is uncertain and may be explained by dynamic changes in NfL post stroke.25 26 Findings from patients with small subcortical infarcts demonstrated that NfL was elevated but eventually returned to normal levels after 15 months.26 In SCANS blood sampling was unfortunately only taken annually not allowing us to test monthly changes in NfL levels. Here, NEFL is linked to Stroke.