High values of NfL are not disease specific as they merely provide an index of central axonal degeneration and have therefore been reported in other neurologic conditions associated with rapid progression or considerable neuronal injury.18, 19 Nonetheless, when it comes to differentiating MSA from Lewy-body synucleinopathies, NfL-c can fulfill the unmet need for a reliable biomarker to solidify the clinical diagnosis.15 Here, NEFL is linked to multiple system atrophy.