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Though there is not a single specific serum or plasma biomarker for ALS, higher levels of serum neurofilament light chain (NfL), a neuron-specific marker of axonal degeneration, have been found to differentiate ALS from disease mimics, such as inflammatory demyelinating polyneuropathy or structural polyradiculopathy [78], and correlates with rate of progression in ALS as well as disease severity [79]

Its mechanism restoring NAD+ availability and reactivating SIRT1-mediated pathways directly addresses mitochondrial dysfunction, impaired glucose tolerance, and hepatic steatosis, all hallmarks of metabolic syndrome

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