NEFL and multiple system atrophy: While elevated levels of NfL are therefore not disease-specific, NfL in CSF has been shown to provide very accurate differentiation between MSA and the Lewy-body synucleinopathies, even before motor symptoms develop.15, 17, 18, 37 In contrast to the highly complex and time-consuming protein aggregation assays, measurements of NfL can be readily achieved using ELISA technology.16