Is Neutrophils / Lymphocytes Ratio Affected During 'Migraine Attacks with Aura' in Migraine Patients?

Purpose: The formation and pathophysiology of migraine attacks with aura are still ambiguous. Sterile inflammation is claimed to play a role in the pathogenesis of migraine. Neutrophil / lymphocyte ratio (NLR) is an inexpensive and practical indicator that can be well detectable from a complete blood count (CBC). This study, it was aimed to compare NLR in migraine patients, during attacks with aura, and without attack. Methods: A total of 98 patients diagnosed with migraine headache with aura and 34 healthy individuals without migraine were analyzed. All subjects were evaluated in terms of age, gender, CBC. NLR results were compared with migraine attacks with aura, periods without attacks, and 34 healthy controls. Results: The 98 patients, migraine with aura, had higher NLR values during attacks than migraine-free episodes and controls (p = 0.000, p = 0.000, respectively). Conclusions: NRL is a marker of inflammation, and we determined that NLR increases in migraine attacks especially as in other acute inflammatory situations. Pain can be prevented by taking, non-steroidal anti-inflammatory drugs (NSAIDs) and triptans which inhibit neurogenic inflammation and neuroinflammation in the cascade, early at the onset of attacks.

___

  • 1. Yücesan C. Migraine and Treatment. J Neurol-Special Topics. 2008;1(1):10-21
  • 2. Dodick DW. A Phase-by-Phase Review of Migraine Pathophysiology. Headache. 2018;58:4-16. https://doi.org/10.1111/head.13300
  • 3. Vanmolkot F, de Hoon J. Increased C-Reactive Protein in Young Adult Patients with Migraine. Cephalalgia. 2007;27(7):843-846. https://doi.org/10.1111/j.1468-2982.2007.01324.x
  • 4. Waeber C, Moskowitz MA. Migraine as an inflammatory disorder. Neurology 2005;64:9-15.
  • 5. Welch KM. Stroke and migraine-the spectrum of cause and effect. Funct Neurol 2003;18:121-126.
  • 6. Muhammed J, Halim SA, Hitam W, Tharakan J. Migraine with aura complicated by “migraine triggered seizures” and “occipital lobe infarction”: A case report. Neurology Asia 2014;19(3):323-326
  • 7. Ramachandran R. Neurogenic inflammation and its role in migraine. Semin Immunopathol. 2018;40(3):301-314. https://doi.org/10.1007/s00281-018-0676-y
  • 8. Ates U, Bahadir K, Ergun E, et al. Determination of Pentraxin 3 levels in diagnosis of Appendicitis in children. Pediatr Int. 2020;62(5):624-8. https://doi.org/10.1111/ped.14131.
  • 9. Azab B, Bhatt VR, Phookan J, et al. Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol. 2012;19(1):217-24. https://doi.org/10.1245/s10434-011-1814-0.
  • 10. Huang WJ, Zhang X, Chen WW. Role of oxidative stress in Alzheimer disease. Biomed Rep. 2016;4(5):519-22. https://doi.org/10.3892/br.2016.630
  • 11. Yazar T, Yazar HO. Evalution of C-reactive protein/albumin ratio according to stage in patients with idiopathic Parkinson disease. Turk J Neurol. 2019;25(3):123-8. https://doi.org/10.4274/tnd.galenos.2019.13334
  • 12. Tekin S, Avcı E, Nar R, et al. Are Monocyte/HDL, Lymphocyte/Monocyte and Neutrophil/Lymphocyte Ratios Prognostic or Follow-up Markers in Ischemic Cerebrovascular Patients?. J Basic Clin Health Sci 2020; 4(1): 038-043. http://dx.doi.org/10.30621/jbachs.2020.837
  • 13. Belotti A, Doni E, Bolis S, et al. Peripheral blood lymphocyte/monocyte ratio predicts outcome in follicular lymphoma and in diffuse large B-cell lymphoma patients in the rituximab era. Clin Lymphoma Myeloma Leuk. 2015;15(4):208-213. https://doi.org/10.1016/j.clml.2014.10.001.
  • 14. Karabulut KU, Egercioglu TU, Uyar M, Ucar Y. The change of neutrophils/lymphocytes ratio in migraine attacks: A case-controlled study. Ann Med Surg (Lond). 2016;10:52-56. https://doi.org/10.1016/j.amsu.2016.07.023
  • 15. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629-808.
  • 16. Vetvik KG, MacGregor EA. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2017;16(1):76-87. https://doi.org/10.1016/S1474-4422(16)30293-9.
  • 17. Buzzi MG, Moskowitz MA. The antimigraine drug, sumatriptan (GR43175) selectively blocks neurogenic plasma extravasation from blood vessels in dura mater Br J Pharmacol. 1990;99(1):202-206.
  • 18. Moskowitz MA, Cutrer FM. Sumatriptan: a receptor-targeted for migraine, Annu. Rev. Med. 1993;44:145-154.
  • 19. Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35(17):6619-6629. https://doi.org/10.1523/JNEUROSCI.0373-15.2015