On top of clinical and neuroimaging disease severity scales, neurofilament light chain concentrations may be employed as a marker of brain injury in Wilson disease.

• This study included 61 treatment-naïve patients to determine if serum concentrations of neurofilament light chain (sNfL) correlate with brain injury in Wilson disease patients.

• Patients with neurological disease had significantly higher concentrations of sNfL than those presenting with other forms (39.7 ± 73.4 pg/mL vs 13.3 ± 9.2 pg/mL).

• Positive correlation of sNfL concentration with neurological severity scores as well as with acute and chronic brain damage based on the neuroimaging scale was found.