Diagnostic value of red blood cell indices and peripheral inflammatory markers in migraine patients during the interictal period

Abstract

Objectives: Current data show that migraine patients exhibit a widespread pro-inflammatory systemic state, present even during the interictal period, becoming even more pronounced during attacks. This study aimed to investigate the potential of red blood cell indices and peripheral inflammatory biomarkers (PIB) measured in the interictal period to distinguish migraine from tension-type headache (TTH).

Methods: This retrospective cross-sectional study included 410 individuals aged 18 to 69 years, comprising 213 (52.0%) with migraine and 197 (48.0%) with tension-type headache (TTH). Peripheral markers of inflammation, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), white blood cell (WBC) count, C-reactive protein (CRP), pan-immune inflammation value (PIV), systemic immune inflammation index (SII) and other blood indices such as hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean platelet volume (MPV), platelet distribution width (PDW), ferritin, vitamin B12 and folic acid values were calculated.

Results: Interictal hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), ferritin, mean platelet volume (MPV), platelet distribution width (PDW), and LMR were significantly lower, whereas red cell distribution width (RDW), platelet count (PLT), PLR, NLR, C-reactive protein (CRP), PIV, and SII were significantly higher in migraine patients compared with TTH patients. The ROC curve analysis revealed that a PIV cutoff of 206.09 demonstrated 94.8% sensitivity and 89.3% specificity, while an SII cutoff of 535.28 resulted in 91.5% sensitivity and 89.3% specificity in distinguishing migraine from TTH.

Conclusions: The SII and PIV indices may be potential biomarkers for distinguishing migraine from TTH. These indices may also help monitor treatment efficacy based on individual inflammatory response profiles during clinical follow-up.