NEFL and coronary artery calcification: Earlier work from the Rotterdam study showed that a higher intracranial arteriosclerosis burden accelerates the development of small vessel disease,7 which is, in turn, associated with higher plasma NfL concentrations.38 Moreover, coronary artery calcification may trigger inflammatory cascades,39 possibly contributing to an upregulation of cytokines and further axonal injury.40 Taken together, these findings point to a broader vascular pathway linking systemic arteriosclerosis to neurodegeneration.