Relationship between migraine headache and hematological parameters

DOI: https://doi.org/10.1007/s13760- 020- 01362- x

Abstract-Summary The aim of this study was to investigate the levels of hematological parameters and neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/ monocyte ratio (LMR) and neutrophil/monocyte ratio (NMR) used as inflammatory markers in patients diagnosed with migraine.

Hematological parameters, C-reactive protein (CRP), NLR, PLR, LMR, NMR

ratios were compared in the patient and control groups.

Patients with migraine were grouped according to loss of function, the severity

of pain and aura.

We found that NMR values in migraine with aura (MWA) were significantly

higher than in the control group.

CRP, PLR and NMR values in migraine without aura (MWOA) were signifi-

cantly higher than in the control group.

2.3 Comorbidities

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Mean platelet volume (MPV) and platelet values were higher in patients with MWA and MWOA compared to the control group but did not show a statistically significant difference.

Extended: The aim of this study was to investigate the hematological parameters and the levels of NLR, PLR, NMR, LMR and CRP used as inflammatory markers in patients diagnosed with migraine.

CRP, PLR and NMR levels of MWOA patients were significantly higher than

healthy subjects, while MON levels were significantly lower.

Mean platelet volume (MPV) is an indicator of platelet function, reflecting plate-

let production, stimulation, and activity [511, 512].

We believe that more comprehensive and controlled studies are needed to evalu-

ate in detail the factors involved in the pathogenesis of migraine.

Introduction Neutrophil/lymphocyte ratio (NLR), as well as platelet/lymphocyte ratio (PLR), neutrophil/monocyte ratio (NMR) and lymphocyte/monocyte (LMR) ratio are inex- pensive and easily calculated indexes used in recent years to evaluate systemic inflammation [513, 514].

CRP levels have been associated with white matter lesions in women with migraine and have been used as a marker of oxidative stress, inflammation and stroke risk [515, 516].

Besides NLR and PLR ratios, LMR and NMR ratios are commonly studied in malignancies, cardiovascular diseases, osteomyelitis, and peripheral arterial dis- eases as indicators of inflammation and prognosis [517–519].

Previous studies investigated NLR and PLR ratios in acute and chronic types of headaches; however, no comprehensive studies are available in the literature inves- tigating these parameters along with LMR and NMR ratios [520, 521].

The aim of this study was to investigate the hematological parameters and the levels of NLR, PLR, NMR, LMR and CRP used as inflammatory markers in patients diagnosed with migraine.

Materials and Methods 215 healthy subjects were included in the study as the control group.

According to the International Classification of Headache Disorders criteria, patients were diagnosed as migraine and the patients were divided into two groups as migraine with aura (MWA) and migraine without aura (MWOA) [522].

The severity of the pain was evaluated using the Visual Analogue Scale (VAS), and loss of function was evaluated using the Migraine Disability Assessment (MIDAS) [139].

Healthy volunteers who applied to the outpatient clinic for a check-up without

any disease were included in the control group.

Demographic characteristics, white blood count (WBC), platelet, neutrophil, lymphocyte, monocyte, MPV and CRP values of the patient and control groups were recorded.

Kolmogorov–Smirnov normality test was applied to numerical variables accord-

ing to groups to decide on the analyses to be applied.

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2 Mechanisms

Kruskal–Wallis analysis was used to examine the differences between more than

two independent groups (e.g. MIDAS) according to the variables.

Results Of the patients diagnosed with migraine, 214 (85.6%) were female and 36 (14.4%) were male.

Of Kruskal–Wallis analysis, CRP, MON, PLR and NMR were found to be statis- tically significantly different between MWOA, MWO patients and healthy subjects (p < 0.05).

CRP, PLR and NMR levels of MWOA patients were significantly higher than

healthy subjects, while MON levels were significantly lower.

NMR levels of MWA patients were significantly higher than healthy subjects (p

< 0.05).

Discussion MPV and platelet values were higher in patients with MWA and MWOA compared to the control group but did not show a statistically significant difference.

Celikbilek and others [523] found a significant increase in platelet values in migraine patients compared to the control group, but no difference in MPV values. CRP values were significantly higher in patients with MWOA than in the control

group (p = 0.000).

Vanmolkot and others [524] found that CRP values were significantly higher in

patients with migraine than in the control group, consistent with our study.

Eryigit and others [525] found no difference in NLR values between patients with migraine and the control group, whereas NLR values of patients with SAH were significantly higher when migraine and subarachnoid haemorrhagic patients were compared.

Acknowledgement A machine generated summary based on the work of Sarıcam, Gulhan. 2020 in Acta Neurologica Belgica.

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