Moreover, in a trial of lamotrigine in SPMS, those patients adherent to therapy had significantly lower serum NfH when compared to the non-adherent group, and patients with detectable NfH had a higher EDSS score and performed worse in the 25 foot-walk and 9-hole peg test [23], suggesting a possible use of this marker to monitor lamotrigine therapy. Here, NEFH is linked to secondary progressive multiple sclerosis.