Evaluation of hematological inflammatory parameters in patients with chronic migraine: a pilot study

IntroductionMigraine is a prevalent and disabling neurological disorder characterized by recurrent attacks of severe, pulsating, unilateral headache accompanied by phonophobia, photophobia, nausea and/or vomiting. Its pathophysiology involves sterile inflammation within the cortex–meninges interface and activation of the trigeminal system. Despite its burden, there are still no laboratory biomarkers established in routine clinical practice for diagnosis, monitoring, or prognostic assessment.ObjectiveTo investigate the feasibility of complete blood count (CBC)–derived parameters and composite indices as potential biomarkers in migraine.MethodsThis retrospective case–control study included individuals aged 18–69 years with chronic migraine and age- and sex-matched controls without migraine. CBC parameters and combined indices were analyzed, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-monocyte ratio (NMR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-monocyte ratio (PMR).ResultsTwenty-five patients with migraine and 29 controls were included. Patients with migraine had a significantly higher NMR compared with controls [11.42 (8.53–12.94) vs 7.76 (6.13–10.17); p=0.029]. No differences were observed in individual CBC parameters or in the other ratios evaluated.ConclusionThese findings suggest a predominance of neutrophil-related activity in migraine-associated inflammation. Larger, prospective studies are needed to validate the diagnostic and prognostic value of NMR.