A Comparative Analysis of Neutrophil-to-Lymphocyte Ratio, Systemic Immune-Inflammation Index, and Hemoglobin-Albumin-Lymphocyte-Platelet Score in Migraine
Journal of Inflammation Research, vol.19, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 19
- Publication Date: 2026
- Doi Number: 10.2147/jir.s625473
- Journal Name: Journal of Inflammation Research
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Keywords: chronic migraine, HALP score, inflammatory biomarkers, migraine, neutrophil-to-lymphocyte ratio, systemic immune–inflammation index
- Open Archive Collection: AVESIS Open Access Collection
- Ankara Yıldırım Beyazıt University Affiliated: Yes
Abstract
Background: Migraine is increasingly recognized as a neuroinflammatory disorder characterized by trigeminovascular activation and cytokine-mediated nociceptive sensitization. While leukocyte-derived indices such as the neutrophil-to-lymphocyte ratio (NLR) and systemic immune–inflammation index (SII) reflect dynamic inflammatory responses, the hemoglobin–albumin–lymphocyte–platelet (HALP) score represents a composite immunonutritional marker associated with chronic systemic inflammation. However, its potential relevance in migraine remains unclear. Methods: In this retrospective cross-sectional study, 115 patients with migraine were included. HALP, NLR, platelet-to-lymphocyte ratio (PLR), and SII were calculated from laboratory parameters obtained within ±14 days of clinical evaluation. Associations with clinical variables were analyzed using correlation and regression analyses. Discriminative performance for chronic versus episodic migraine was assessed using receiver operating characteristic (ROC) curve analysis with Youden index estimation. Results: Among the 115 included patients, 99 (86.1%) had episodic migraine and 16 (13.9%) had chronic migraine. HALP was not associated with monthly headache frequency, disease duration, or analgesic use and showed limited discriminative performance. In contrast, NLR and SII were significantly elevated in chronic migraine and demonstrated moderate discriminatory ability for differentiating chronic from episodic migraine (AUC = 0.734 and 0.723, respectively). However, these estimates should be interpreted cautiously given the relatively small chronic migraine subgroup. Conclusion: These findings suggest that migraine-related inflammatory processes may be more sensitively reflected by rapidly responsive leukocyte-derived indices than by composite immunonutritional markers such as HALP. The lack of association between HALP and clinical features may indicate that systemic inflammatory involvement in migraine is limited or variable, rather than persistently elevated.