Kronik Migrende Sistemik İmmün-İnflamasyon İndeksi ile Migren Dizabilitesi (MIDAS) Arasındaki İlişki

Year 2026, Volume: 10 Issue: 1 , 88 - 97 , 29.04.2026

Deniz Kamacı Şener , Özden Kamışlı

https://doi.org/10.46332/aemj.1735273

https://izlik.org/JA49XM86NE

Abstract

Amaç: Migren, patofizyolojisinde nöroinflamasyonun rol oynadığı kompleks bir nörolojik hastalıktır. Sistemik İmmün-İnflamasyon İndeksi (SII), trombosit sayısı × nötrofil/lenfosit oranı kullanılarak hesaplanan ve sistemik inflamasyonu yansıtabilen bir parametredir. Bu çalışmanın amacı, kronik migrende sistemik inflamasyon ile Migren Dizabilite Değerlendirme Ölçeği (MIDAS) ile değerlendirilen migrene bağlı dizabilite arasındaki ilişkiyi incelemektir.

Araçlar ve Yöntem: Çalışmaya 18–60 yaş aralığında 71 kronik migren hastası ve 63 sağlıklı kontrol dahil edilmiştir. Hastaların demografik özellikleri, migren atak süresi, migren hastalık süresi, görsel analog skala (VAS) ile değerlendirilen ağrı şiddeti ve migrene bağlı dizabilite skorları kaydedilmiştir. SII, nötrofil/lenfosit oranı (NLR), trombosit/lenfosit oranı (PLR) ve trombosit/nötrofil oranı (PNR) gibi inflamatuvar parametreler gruplar arasında karşılaştırılmıştır. Ayrıca bu parametreler ile MIDAS skorları, VAS, migren süresi ve atak süresi arasındaki ilişkiler analiz edilmiştir.

Bulgular: Kronik migren hastalarında lenfosit sayıları daha yüksek bulunurken, auralı migren hastalarında hemoglobin düzeyleri daha düşük saptanmıştır. MIDAS skorları ile NLR, PLR, PNR ve SII arasında anlamlı bir ilişki bulunmamıştır. KM hastalarında ağrı süresi arttıkça NLR ve SII değerlerinin arttığı görülmüştür.

Sonuç: SII, sistemik inflamasyonu yansıtabilecek kolay erişilebilir ve düşük maliyetli bir belirteç olmakla birlikte, bu çalışmada kronik migren hastalarında MIDAS ile değerlendirilen migrene bağlı dizabilite ile ilişkili bulunmamıştır. SII’nin kronik migrendeki rolünü netleştirmek için daha geniş örneklemli ve prospektif çalışmalara ihtiyaç vardır.

Keywords

Kronik migren , Migren , Nöroinflamasyon , Migren Dizabilite değerlendirme ölçeği (MIDAS)

Ethical Statement

Çalışma protokolü, Bursa Şehir Hastanesi Etik Kurulu tarafından onaylanmış ve Dünya Tabipler Birliği Helsinki Bildirgesi'ne uygun olarak hazırlanmıştır (Etik kurul tarih ve sayısı: 30.04.2025/2024-9/12).

Relationship Between Systemic Immune-Inflammation Index and Migraine Disability (MIDAS) in Chronic Migraine

https://izlik.org/JA49XM86NE

Abstract

Purpose: Migraine is a complex neurological disease in which neuroinflammation plays a role in its pathophysiology. The Systemic Immune-Inflammation Index (SII) defined as [platelet count × neutrophil-to-lymphocyte ratio] is a parameter that can be used to indicate systemic inflammation during the course of the disease. This study aimed to investigate the relationship between systemic
inflammation and migraine-related disability, assessed by the Migraine Disability Assessment Test (MIDAS), in patients with chronic migraine (CM).

Materials and Methods: The study included 71 patients with chronic migraine (CM) and 63 healthy controls aged 18–60 years. Demographic characteristics, migraine attack duration, migraine disease duration, pain intensity assessed by the visual analogue scale (VAS), and migraine-related disability scores were recorded. Inflammatory parameters, including the Systemic ImmuneInflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and platelet-to-neutrophil ratio (PNR), were compared between the groups. In addition, the relationships between these inflammatory parameters and MIDAS scores, VAS scores, migraine duration, and attack duration were analyzed.

Results: In this study, lymphocyte counts were higher in patients with chronic migraine (CM), whereas haemoglobin levels were lower in patients with migraine with aura. No significant correlation was found between MIDAS scores and NLR, PLR, PNR, or SII. However, NLR and SII values were found to increase with increasing pain duration in patients with CM.

Conclusion: Although the Systemic Immune-Inflammation Index (SII) is an easily accessible and inexpensive marker of systemic inflammation, it was not associated with migraine-related disability assessed by the Migraine Disability Assessment Test (MIDAS) in patients with chronic migraine. Further large-scale and prospective studies are needed to clarify the role of SII in chronic migraine.

Keywords

Chronic migraine , Migraine , Neuroinflammation , Migraine diability assesment scale (MIDAS)

Ethical Statement

The study protocol was approved by the ethics committee of Bursa City Hospital and was prepared in accordance with the Helsinki Declaration of the World Medical Association. (Ethics committee date and number: 30.04.2025/2024-9/12)

References

• 1. Parisi P, Belcastro V, Verrotti A, et al. Ictal epileptic headache and the revised International Headache Classification (ICHD-3): not just a matter of definition. Epilepsy Behav. 2018;87:243-245. doi:10.1016/j.yebeh.2018.07.018
• 2. Olesen J, Steiner T. The International Classification of Headache Disorders. 2nd ed. London: BMJ Publishing Group Ltd;2004:808-811. doi:10.1136/jnnp.2003.031286
• 3. Khanal S, Underwood M, Naghdi S, et al. A systematic review of economic evaluations of pharmacological treatments for adults with chronic migraine. J Headache Pain. 2022;23(1):122. doi:10.1186/s10194-022-01492-y
• 4. Edvinsson L, Haanes KA, Warfvinge K. Does inflammation have a role in migraine? Nat Rev Neurol. 2019;15(8):483-490. doi:10.1038/s41582-019-0216-y
• 5. Zhang S, Azubuine J, Schmeer C. A systematic literature review on the role of glial cells in the pathomechanisms of migraine. Front Mol Neurosci. 2023;16:1219574. doi:10.3389/fnmol.2023.1219574
• 6. Gilhus NE, Deuschl G. Neuroinflammation—a common thread in neurological disorders. Nat Rev Neurol. 2019;15(8):429-430. doi:10.1038/s41582-019-0227-8
• 7. Li H, Fu Q, Philips K, et al. Leukocyte inflammatory phenotype and function in migraine patients compared with matched non-migraine volunteers: a pilot study. BMC Neurol. 2022;22(1):278. doi:10.1186/s12883-022-02781-4
• 8. Poyrazoğlu HG, Öztürk AB. Predictive value of laboratory parameters in childhood migraine. Acta Neurol Belg.2020;120:907-914. doi:10.1007/s13760-019-01106-6
• 9. Karabulut KU, Egercioglu TU, Uyar M, et al. The change of neutrophils/lymphocytes ratio in migraine attacks: A casecontrolled study. Ann Med Surg. 2016;10:52-56. doi:10.1016/j.amsu.2016.07.023
• 10. Yang R, Chang Q, Meng X, et al. Prognostic value of systemic immune-inflammation index in cancer: a meta-analysis. J Cancer. 2018;9(18):3295. doi:10.7150/jca.25691
• 11. Fois AG, Paliogiannis P, Scano V, et al. The systemic inflammation index on admission predicts in-hospital mortality in COVID-19 patients. Molecules. 2020;25(23):5725. doi:10.3390/molecules25235725
• 12. Mehdiyev DA, Ayas ZÖ. Systemic immune-inflammation index in patients with migraine: clinical, scale and radiological characteristics. North Clin Istanb. 2023;11(3):231-239. doi:10.4274/nkmj.galenos.2023.03016
• 13. Sadri S, Ülfer G, Polat B. The value of the systemic immune inflammation index (SII) in migraine patients treated with greater occipital block treatment. Sanamed. 2023;18(2): 119-126. doi:10.5937/sanamed0-44601
• 14. Demartini C, Francavilla M, Zanaboni AM, et al. Biomarkers of migraine: an integrated evaluation of preclinical and clinical findings. Int J Mol Sci. 2023;24(6):5334. doi:10.3390/ijms24065334
• 15. Ashina M, Terwindt GM, Al-Karagholi MA-M, et al. Migraine: disease characterisation, biomarkers, and precision medicine. Lancet. 2021;397(10283):1496-1504. doi:10.1016/S0140-6736(20)32162-0
• 16. Köklü E, Yüksel İÖ, Arslan Ş, et al. Is elevated neutrophil-to-lymphocyte ratio a predictor of stroke in patients with intermediate carotid artery stenosis? J Stroke Cerebrovasc Dis. 2016;25(3):578-584. doi:10.1016/j.jstrokecerebrovasdis.2015.10.031
• 17. Gomez D, Farid S, Malik H, et al. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma. World J Surg. 2008;32:1757-1762. doi:10.1007/s00268-008-9552-6
• 18. Yazar HO, Yazar T, Aygün A, et al. Evaluation of simple inflammatory blood parameters in patients with migraine. Ir J Med Sci. 2020;189(2):677-683. doi:10.1007/s11845-019-02136-y
• 19. Sarıcam G. Relationship between migraine headache and hematological parameters. Acta Neurol Belg. 2021;121(4):899-905. doi:10.1007/s13760-020-01362-x
• 20. Eryigit U, Cakmak VA, Sahin A, et al. The diagnostic value of the neutrophil-lymphocyte ratio in distinguishing between subarachnoid hemorrhage and migraine. Am J Emerg Med. 2017;35(9):1276-1280. doi:10.1016/j.ajem.2017.03.063
• 21. Wijeratne T, Murphy MJ, Wijeratne C, et al. Serial systemic immune inflammation indices: markers of acute migraine events or indicators of persistent inflammatory status? J Headache Pain. 2025;26(1):7. doi:10.1186/s10194-024-01929-6
• 22. Gür-Özmen S, Karahan-Özcan R. Iron deficiency anemia is associated with menstrual migraine: A case–control study. Pain Med. 2016;17(3):596-605. doi:10.1093/pm/pnv029
• 23. Sari U, Başcı Ö. Association between anemia severity and migraine in iron deficiency anemia. Eur Rev Med Pharmacol Sci. 2024;28(3):995-1001.
• 24. Patel KV, Ferrucci L, Ershler WB, et al. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med. 2009;169(5):515-523. doi:10.1001/archinternmed.2009.11
• 25. Freedman JE, Loscalzo J. Platelet–monocyte aggregates: bridging thrombosis and inflammation. Circulation.2002;105:2130-2132. doi:10.1161/01.CIR.0000017140.26466.F5
• 26. Zeller J, Lindner V, Frahm K, et al. Platelet activation and platelet–leucocyte interaction in patients with migraine: subtype differences and influence of triptans. Cephalalgia. 2005;25(7):536-541. doi:10.1111/j.1468-2982.2005.00916.x
• 27. Cotrim MD, Ribeiro CAF, Macedo TRA. Changes in platelet membrane fluidity of migraine patients. Cephalalgia. 1993;13(2):99-101. doi:10.1046/j.1468-2982.1993.1302099.x
• 28. Celikbilek A, Zararsiz G, Atalay T, et al. Red cell distribution width in migraine. Int J Lab Hematol. 2013;35(6): 620-628. doi:10.1111/ijlh.12100
• 29. Varol S, Akıl E, Çevik MU, et al. Investigation of mean platelet volume and platelet count in the blood of patients with migraine. Turk J Neurol. 2013;19(3):90-92. doi:10.4274/Tnd.88156
• 30. Jeon K, Kim M, Lee J, et al. Immature platelet fraction: a useful marker for identifying the cause of thrombocytopenia and predicting platelet recovery. Medicine (Baltimore). 2020;99:e19076. doi:10.1097/MD.0000000000019096.
• 31. Mukker P, Kiran S. Platelet indices evaluation in patients with dengue fever. Int J Res Med Sci. 2018;6(6):2054. doi:10.18203/2320-6012.ijrms20182287
• 32. Trivedi AS, Chakrabarti D, Khasnabish S, et al. High sensitive CRP and platelet volume indices in acute coronary syndrome and their impact in prognostication. J Indian Med Assoc. 2024;122(4):38-42.
• 33. Xu Y, Eng Hwa W, Bin Nordin R, et al. Risk factors for ischemic stroke in China: a case-control study. F1000Res. 2024;13:355. doi:10.12688/f1000research.143163.1
• 34. Cohen F, Brooks CV, Sun D, et al. Prevalence and burden of migraine in the United States: a systematic review. Headache. 2024;64(5):516-532. doi:10.1111/head.14709