The relationship between leukocyte-based inflammation indices and essential tremor

Year 2024, Volume: 15 Issue: 3, 473 - 480, 30.09.2024

Demet Aygün , Bagnu Dundar

https://doi.org/10.18663/tjcl.1503503

Abstract

Aim: Previous limited studies have indicated that pro-inflammatory cytokines are elevated in patients with essential tremor (ET). This elevation could lead to a more pronounced inflammatory response in these patients. Thus, this study aimed to investigate the relationship between leukocyte-based inflammatory indices and ET.
Material and Methods: In this retrospective study, 103 patients diagnosed with ET between January 2021 and December 2023 were included, along with 103 healthy individuals who were matched by age and gender, participated in check-up programs, and had no other comorbidities. To evaluate tremor severity, the Fahn-Tolosa-Marin (FTM) tremor rating scale was utilized. The leukocyte-based inflammatory indices were calculated as follows: NLR= neutrophils / lymphocytes, PLR = platelets / lymphocytes, systemic immune-inflammation index (SII) = platelets × neutrophils / lymphocytes, and systemic inflammatory response index (SIRI) = neutrophils × monocytes / lymphocytes.
Results: The ET group exhibited higher levels of leukocytes, their subtypes, CRP and leukocyte-based inflammatory indices compared to the control group. Increased CRP (OR= 3.71, p < 0.001) and SIRI (OR= 11.73, p < 0.001) levels were independent predictors of ET. In predicting ET. SIRI exhibited superior diagnostic performance compared to other inflammatory parameters. The threshold for SIRI levels was set at 7 and above, with a sensitivity of 85.4% and a specificity of 82.5%. There was a positive correlation between SIRI and FTM scores.
Conclusion: Among the leukocyte-based inflammation indices, SIRI demonstrated superior diagnostic performance in predicting ET and was associated with higher tremor severity. This suggests that inflammation may play a potential role in the pathophysiology of ET.

Keywords

essential tremor, inflammation, tremor severity, systemic immune-inflammation index

Ethical Statement

The study was performed in accordance with the Declaration of Helsinki, and was approved by the Istanbul Atlas University Medicine Hospital Clinical Research Ethics Committee (Date: 15.02.2023, Decision No: E-22686390-050.99-24274).

Project Number

E-22686390-050.99-24274

Lökosit bazlı enflamasyon indeksleri ile esansiyel tremor arasındaki ilişki

Abstract

Amaç: Daha önce yapılan sınırlı çalışmalar, esansiyel tremor (ET) hastalarında proinflamatuar sitokinlerin arttığını göstermiştir. Bu artış, bu hastalarda daha belirgin bir inflamatuar yanıtı tetikleyebilir. Bu nedenle, bu çalışma lökosit bazlı inflamasyon indeksleri ile ET arasındaki ilişkiyi araştırmayı amaçladı.
Gereç ve Yöntemler: Bu retrospektif çalışmaya, Ocak 2021 ile Aralık 2023 arasında ET tanısı alan 103 hasta ile yaş ve cinsiyet açısından eşleştirilen, check-up programlarına katılan ve başka komorbiditesi olmayan 103 sağlıklı birey dahil edilmiştir. Tremor şiddetini değerlendirmek için Fahn-Tolosa-Marin (FTM) tremor derecelendirme skalası kullanılmıştır. Lökosit bazlı inflamasyon indeksleri şu şekilde hesaplanmıştır: NLR = nötrofiller / lenfositler, PLR = trombositler / lenfositler, sistemik immün-enflamasyon indeksi (SII) = trombositler × nötrofiller / lenfositler ve sistemik inflamatuar yanıt indeksi (SIRI) = nötrofiller × monositler / lenfositler.
Bulgular: ET grubunda lökosit, alt tipleri, CRP ve lökosit bazlı inflamasyon indeksleri kontrol grubuna göre daha yüksek seviyelerdeydi. Artmış CRP (OR = 3.71, p < 0.001) ve SIRI (OR = 11.73, p < 0.001) seviyeleri, ET’nin bağımsız öngörücüleri olarak belirlendi. ET’yi öngörmede, SIRI diğer inflamatuar parametrelere göre üstün bir tanısal performans sergilemiştir. SIRI seviyeleri için eşik değer 7 ve üzeri olarak belirlendi ve bu değer %85.4 duyarlılık ve %82.5 özgüllük gösterdi. SIRI ile FTM skorları arasında pozitif bir korelasyon bulundu.
Sonuçlar: Lökosit bazlı inflamasyon indeksleri arasında, SIRI ET’yi öngörmede üstün bir tanısal performans sergilemiş ve daha yüksek tremor şiddeti ile ilişkilendirilmiştir. Bu da inflamasyonun ET’nin patofizyolojisinde potansiyel bir rol oynayabileceğini düşündürmektedir.

Keywords

esansiyel tremor, inflamasyon, tremor şiddeti, sistemik immün-enflamasyon indeksi

Project Number

E-22686390-050.99-24274

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