Therefore, we designed a cross-sectional study on a cohort of 40 adult FD patients being followed up at our institution, aiming to assess: (i) prevalence and clinical correlates of cerebrovascular and cognitive manifestations in FD, taking into account the role that FD-related cardiac or renal manifestations may have in CNS involvement; and (ii) the potential value of known disease biomarkers, i.e., residual alpha-Gal A activity, plasma lyso-Gb3 and serum neurofilament light chain (NfL) levels as indicators of WML load in FD. The gene discussed is NEFL; the disease is Fabry disease.