Abstract Number: Esoc2026a2110 the Importance of Circulating Neurofilament Light Chain (Nfl) Protein in Cerebrovascular Diseases – A Systematic Narrative Review

Background and aims Recent years have shown an increase in research regarding biomarkers to detect neuroaxonal injury. Neurofilament light chain (NfL), a scaffolding axonal protein, has already demonstrated promising diagnostic and prognostic value in virtually all neurological diseases including stroke and other cerebrovascular disorders. The aim of this study is to conduct a systematic review that explores the diagnostic and prognostic relevance of blood NFL in patients with cerebrovascular disease in order to provide clinicians with a comprehensive and up-to-date overview to facilitate informed interpretation. Methods We systematically searched multiple literature databases following the PRISMA guidelines for systematic reviews, focusing on investigations on NFL in cerebrovascular diseases. Results We identified 984 recent publications and after reviewing abstracts for relevance 171 trials and experiments were assessed. The review is divided into five chapters: 1) the preclinical evidence of Nf metabolism and different methods of measuring, 2) predictive properties of NfL in the context of future cerebrovascular events providing a table of all trials published up until 2026 3) prognosis regarding outcome and rehabilitation after stroke 4) rare cerebrovascular diseases, such as CADASIL and 5) intracerebral hemorrhage (ICH). Conclusions NfL seems to be a very sensitive biomarker of neuroaxonal damage with promising results across different types of neurovascular disease in both acute and chronic stroke phases. Research data support its use in multiple clinical settings but validation studies in real-world contexts are needed. Conflict of interest Mark A. Kreye: nothing to disclose, Johannes Teller: nothing to disclose, Hans Worthmann: nothing to disclose, Maria M. Gabriel: nothing to disclose, Lorenzo Barba: nothing to disclose.