The Relationship of Migraine Headache with Neutrophil-Lymphocyte Ratio, Platelet Lymphocyte Ratio and Erythrocyte Distribution Width

Abstract

Objective: The aim of this study was to investigate the availability of neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and erythrocyte distribution width (RDW) values in the differential diagnosis of migraine headache from other headachesMethods: The health records of the patients diagnosed with migraine and other headache who applied to the neurology outpatient clinic between 01/01/2018 and 31/12/2020 were included in the study. RDW, NLR and PLR were calculated and compared between migraine and other headaches.Results: A total of 2528 records were included in the study, 117 (4.6%) with the migraine diagnosis and 2411 (95.4%) with the diagnosis other headaches. The rate of women in the migraine diagnosis group (82.9%) was significantly higher than the other headaches (65.6%). There was no significant difference between migraines and other headaches mean NLR values (2.02± 1.05 and 2.27 ± 2.36), mean PLO values (127.70 ± 68.78 and 128.05 ± 92.57) and mean RDW values (14.18 ± 1.48 and 14.19 ± 1.73) (p> 0.05).Conclusion: No significant difference was found between the NLR, PLO and RDW values of migraine and other headache patients in this study. It was concluded that these values are not useful for differential diagnosis between migraine and other headaches.

Keywords

• Migraine
• Neutrophyl-Lymphocyte Ratio (NLR)
• Platelet Lymphocyte Ratio (PLR)
• Red Cell Distribution Width (RDW)

Migren Baş Ağrısının Nötrofil-Lenfosit Oranı, Platelet Lenfosit Oranı ve Eritrosit Dağılım Genişliği ile İlişkisi

Abstract

Amaç: Bu çalışmada, nötrofil lenfosit oranı (NLO), platelet lenfosit oranı (PLO) ve eritrosit dağılım genişliği (RDW) değerlerinin migren baş ağrısının diğer baş ağrılarından ayırıcı tanısında kullanılabilirliğini incelemek amaçlanmıştır.Yöntem: Çalışmaya nöroloji polikliniğine 01/01/2018 ve 31/12/2020 tarihleri arasında başvuran migren ve diğer baş ağrısı tanısı almış hastaların kayıtları alınmıştır. Bu kayıtlardan eritrosit dağılım genişliği (RDW) değerine ek olarak nötrofil-lenfosit oranı (NLO), platelet lenfosit oranı (PLO) hesaplanmıştır. Migren tanılı hastalar ile diğer baş ağrısı tanıla hastalar arasında karşılaştırma yapılarak NLO, PLO ve RDW açısından fark olup olmadığı incelenmiştir.Bulgular: Çalışmaya toplam 2535 kayıt dahil edilmiştir. Migren tanı grubunda 117 (%4,6) diğer baş ağrıları tanı grubunda 2411 (%95,4) kayıt mevcuttu. Migren tanı grubunda kadın oranı (%82,9) diğer baş ağrıları tanı grubundaki kadın oranından (%65,6) anlamlı yüksekti. Çalışma ve kontrol gruplarının ortalama NLO değerleri (2,02±1,05 ve 2,27±2,36), ortalama PLO değerleri (127,70±68,78 ve 128,05±92,57) ve ortalama RDW değerleri (14,18±1,48 ve 14,19±1,73) arasında anlamlı bir fark izlenmedi (p>0,05).Sonuç: Bu çalışmada migren hastaları ile diğer baş ağrısı tanılı hastaların NLO, PLO ve RDW değerleri arasında anlamlı farklılık bulunmamıştır. Bu değerlerin migren ile diğer baş ağrısı tanıları arasında ayırıcı tanı için kullanım değerleri olmadığı sonucuna varılmıştır.

Keywords

• Migren
• Nötrofil-Lenfosit Oranı (NLO)
• Platelet Lenfosit Oranı (PLO)
• Eritrosit Dağılım Genişliği (RDW)

References

1. Diamond S. A fresh look at migraine therapy. Postgrad Med 2001;109:49-54. https://doi.org/10.3810/pgm.2001.01.822.
2. Rasmussen BK. Epidemiology of headache. Cephalalgia 2001;21:774-7. https://doi.org/10.1177/033310240102100708.
3. Moskowitz MA. Neurogenic inflammation in the pathophysiology and treatment of migraine. Neurology 1993; 43(Suppl 3):16-20.
4. Reuter U, Bolay H, Jansen-Olesen I, Chiarugi A, Sanchez del Rio M, Letourneau R, et al. Delayed inflammation in rat meninges: implications for migraine pathophysiology. Brain 2001; 124:2490-502. https://doi.org/10.1093/brain/124.12.2490.
5. Pichler M, Hutterer GC, Stoeckigt C, Chromecki TF, Stojakovic T, Golbeck S, et al. Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients. Br J Cancer 2013;108:901-7. https://doi.org/10.1038/bjc.2013.28.
6. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2014;23:1204-12. https://doi.org/10.1158/1055-9965.EPI-14-0146.
7. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133:628-32. https://doi.org/10.1043/1543-2165-133.4.628.
8. Yilmaz Avci A, Akalin O. Migraine and peripheral inflammation. Acta Medica Alanya 2017;1(3): 20-6. https://doi.org/10.30565/medalanya.336902.

9. Sarıcam G. Relationship between migraine headache and hematological parameters. Acta Neurologica Belgica 2020;https://doi.org/10.1007/s13760-020-01362-x [Online ahead of print].
10. Bolay H, Reuter U, Dunn AK, Huang Z, BoasDA, Moskowitz MA. Intrinsic brain activity triggers trigeminal meningeal afferents in migraine model. Nat Med 2002;8(2):136–42. https://doi.org/10.1038/nm0202-136.Hamed SA. The vascular risk associations with migraine: Relation to migraine susceptibility and progression. J Atherosclerosis 2009;205(1): 15-22. doi:10.1016/j.atherosclerosis.2008.10.016.
11. Hamed SA. The vascular risk associations with migraine: Relation to migraine susceptibility and progression. J Atherosclerosis 2009;205(1): 15-22. https://doi.org/10.1016/j.atherosclerosis.2008.10.016.
12. Moskowitz MA, Cutrer FM. Sumatriptan: a receptor-targeted for migraine. Annu Rev Med 1993;44:145-54. https://doi.org/10.1146/annurev.me.44.020193.001045.
13. Waeber C, Moskowitz MA. Migraine as an inflammatory disorder. Neurology 2005;64(10Suppl2): S9–S15. https://doi.org/10.1212/wnl.64.10_suppl_2.s9.
14. Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extrecerebral circulation of humans during migraine headache. Ann Neurol 1990;28(2):183–7. https://doi.org/10.1002/ana.410280213.
15. Turan H, Horasanli B, Ugur M, Arslan H. Procalcitonin levels in migraine patients. Can J Neurol Sci 2011;38:124-8. https://doi.org/10.1017/s0317167100011161.
16. Soehlein O. Multipleroles for neutophils in atherosclerosis. Circ Res 2012;110(6):875– 88. https://doi.org/10.1161/CIRCRESAHA.111.257535.
17. Lahoute C, Herbin O, Mallat Z, Tedgui A. Adaptive immunity in atherosclerosis: mechanisms and future therapeutic targets. Nat Rev Cardiol 2011;8(6):348–58. https://doi.org/10.1038/nrcardio.2011.62.
18. Empl M, Sostak P, Breckner M, Riedel M, Muller N, Gruber R et al. T-cell subsets and expression of integrins in peripheral blood of patients with migraine. Cephalalgia 1999; 19:713–7. https://doi.org/10.1046/j.1468-2982.1999.019008713.x.
19. Danese E, Montagnana M, Lippi G. Platelets and migraine. Thromb Res 2014;134(1):17–22. https://doi.org/10.1016/j.thromres.2014.03.055.
20. Zeller JA, Frahm K, Baron R, Stingele R, Deuschl G. Platelet-leukocyte interaction and platelet activation in migraine: a link to ischemic stroke? J Neurol Neurosurg Psychiatry 2004;75(7):984–7. https://doi.org/10.1136/jnnp.2003.019638.
21. Karabulut KU, Egercioglu TU, Uyar M, Ucar Y. The change of neutrophils/lymphocytes ratio in migraine attacks: a case-controlled study. Ann Med Surg 2016;27(10):52–69. https://doi.org/10.1016/j.amsu.2016.07.023.
22. Nelson KB, Richardson AK, He J, Lateef TM, Khoromi S, Merikangas KR. Headache and biomarkers predictive of vascular disease in a representative sample of US children. Arch Pediatr Adolesc Med 2010;164(4):358–62. https://doi.org/10.1001/archpediatrics.2010.17.Freedman JE, Loscalzo J. Platelet–monocyte aggregates: bridging thrombosis and inflammation. Circulation 2002;105(18):2130–2. doi:10.1161/01.cir.0000017140.26466.f5.
23. Zeller JA, Lindner V, Frahm K, Baron R, Deuschl G. Platelet activation and platelet-leucocyte interaction in patients with migraine subtype differences and influence of triptans. Cephalalgia 2005;25(7):536–41. https://doi.org/10.1111/j.1468-2982.2005.00916.x.
24. Freedman JE, Loscalzo J. Platelet–monocyte aggregates: bridging thrombosis and inflammation. Circulation 2002;105(18):2130–2. https://doi.org/10.1161/01.cir.0000017140.26466.f5.
25. Varol S, Akıl E, Ugur M, et al., Investigation of mean platelet volume and platelet count in the blood of patients with migraine, Turk J Neurol 2013;19(3):90-2. https://doi.org/10.4274/Tnd.88156
26. Eryigit U, Altunayoglu Cakmak V, Sahin A, Tatli O, Pasli S, Gazioglu G, Karaca Y. The diagnostic value of the neutrophil-lymphocyte ratio in distinguishing between subarachnoid hemorrhage and migraine. Am J Emerg Med 2017;35(9):1276–80. https://doi.org/10.1016/j.ajem.2017.03.063.
27. Danese E, Lippe G, Montagnana M. Red blood cell distribution width and cardiovascular diseases J Thorac Dis 2015;7:E402-11. https://doi.org/10.3978/j.issn.2072-1439.2015.10.04.
28. Zorlu A, Bektasoglu G, Guven FM, Dogan OT, Gucuk E, Ege MR, et al. Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism. Am J Cardiol 2012;109:128-34. https://doi.org/10.1016/j.amjcard.2011.08.015.
29. Oh HJ, Park JT, Kim JK, Yoo DE, Kim SJ, Han SH, et al. Red blood cell distribution width is an independent predictor of mortality in acute kidney injury patient streated with continuous renal replacement therapy. Nephrol Dial Transplant 2010;27:589-94. https://doi.org/10.1093/ndt/gfr307.
30. Semba RD, Patel KV, Ferrucci L. Serum antioxidants and inflammation predict red cell distribution width in older women: the Women’s Health and Aging Study I. Clin Nutr 2010;29:600-4. https://doi.org/10.1016/j.clnu.2010.03.001.
31. Patel KV, Semba RD, Ferrucci L. Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci 2010;65:258-65. https://doi.org/10.1093/gerona/glp163.
32. Celikbilek A, Zararsiz G, Atalay T, Tanik N. Red cell distribution width in migraine. Int J Lab Hematol 2013;35(6):620-8. https://doi.org/10.1111/ijlh.12100.
33. Özözen Ayas Z. Eritrosit dağılım genişliği: migren-ilişkili beyin mrg lezyonları için yeni bir belirteç mi? Namık Kemal Medical Journal 2020;8(2):186-90. https://doi.org/10.37696/nkmj.641380 Ocak Ö, Şahin