A BSTRACT Background: Moyamoya disease (MMD) is a rare cerebrovascular condition of uncertain aetiology. Immune-inflammatory markers, such as the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index, have garnered interest for their potential to elucidate the immune-inflammatory state in various conditions. Objective: To investigate the role of immune-inflammatory markers in patients with MMD. Methods: A total of 105 patients were included, comprising 55 MMD patients (cases) and 50 age- and sex-matched controls with degenerative spine disease. Complete blood count parameters were analysed to calculate the immune-inflammatory markers. Results: The mean levels of immune-inflammatory biomarkers were significantly higher in the case group compared to the control group ( P < 0.001). Notable sex-based differences were observed with significantly elevated markers in female patients compared to males ( P = 0.025). However, no significant differences were found between paediatric and adult subgroups ( P = 0.5) or between haemorrhagic and ischemic subgroups ( P = 0.5). Conclusion: This study demonstrated significantly elevated immune-inflammatory markers in patients with MMD, with notably higher levels observed among females, suggesting a possible hormonal influence. However, as our study did not include direct hormonal assessments, this association remains speculative. No significant differences were noted between paediatric and adult populations or between ischemic and haemorrhagic presentations. Further well-designed studies incorporating hormonal profiling are necessary to clarify the underlying mechanisms and validate the observed sex-related inflammatory variation.
Tataskar et al. (Sat,) studied this question.