Öz

Objective: The aim of this study was to evaluate potential neuroinflammatory processes in pediatric migraine using hematological inflammatory indices and to examine their associations with age and gender.

Materials and Methods: This retrospective cross-sectional study included 90 children diagnosed with migraine and healthy control group, conducted between August 1, 2019, and August 1, 2025. Complete blood count parameters were analyzed for all participants. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and other hematological inflammatory markers were calculated. Comparisons were made between the migraine and control groups. Additionally, the migraine group was subdivided according to age, gender, and treatment status, and subgroup analyses were performed.

Results: Platelet-to-lymphocyte ratio values were significantly higher in the migraine group than in the control group. In gender-based comparisons, a statistically significant difference was observed only in red blood cell (RBC) counts, whereas no gender-related differences were detected in other inflammatory parameters. Within the migraine group, lymphocyte counts decreased in the older age subgroup, while platelet counts and NLR values showed a significant increase. Among patients receiving flunarizine treatment, no significant differences were observed in inflammatory markers, except for mean corpuscular volume (MCV).

Conclusion: Platelet-to-lymphocyte ratio may serve as a marker of increased inflammatory burden  in pediatric patients with migraine. The age-related increase in inflammatory indices may reflect  neuroinflammatory processes involved in migraine pathophysiology. These findings highlight the importance of considering age in the clinical evaluation of pediatric migraine patients.

Kaynakça

  1. Khan A, Liu S, Tao F. Mechanisms Underlying Sex Differences in Temporomandibular Disorders and Their Comorbidity with Migraine. Brain Sci. 2024;14(7):707. https://doi.org/10.3390/brainsci14070707
  2. Goel K, Chhetri A, Ludhiadch A, Munshi A. Current Update on Categorization of Migraine Subtypes on the Basis of Genetic Variation: a Systematic Review. Mol Neurobiol. 2024;61(7):4804-33. https://doi.org/10.1007/s12035-023-03837-3
  3. Szperka C. Headache in Children and Adolescents. Continuum (Minneap Minn). 2021;27(3):703-31. https://doi.org/10.1212/CON.0000000000000993
  4. Borsook D, Erpelding N, Lebel A, et al. Sex and the migraine brain. Neurobiol Dis. 2014;68:200-14. https://doi.org/10.1016/j.nbd.2014.03.008
  5. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. https://doi.org/10.1177/0333102417738202
  6. Noseda R, Burstein R. Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, CSD, sensitization and modulation of pain. Pain. 2013;154 Suppl 1. https://doi.org/10.1016/j.pain.2013.07.021.
  7. Bruno PP, Carpino F, Carpino G, Zicari A. An overview on immune system and migraine. Eur Rev Med Pharmacol Sci. 2007;11(4):245-8.
  8. Franceschini A, Vilotti S, Ferrari MD, van den Maagdenberg AM, Nistri A, Fabbretti E. TNFα levels and macrophages expression reflect an inflammatory potential of trigeminal ganglia in a mouse model of familial hemiplegic migraine. PLoS One. 2013;8(1):e52394. https://doi.org/10.1371/journal.pone.0052394
  9. Oliveira AB, Bachi ALL, Ribeiro RT, Mello MT, Tufik S, Peres MFP. Unbalanced plasma TNF-α and IL-12/IL-10 profile in women with migraine is associated with psychological and physiological outcomes. J Neuroimmunol. 2017;313:138-44. https://doi.org/10.1016/j.jneuroim.2017.09.008.
  10. Geng C, Yang Z, Xu P, Zhang H. Aberrations in peripheral inflammatory cytokine levels in migraine: A systematic review and meta-analysis. J Clin Neurosci. 2022;98:213-8. https://doi.org/10.1016/j.jocn.2022.02.026.
  11. Eslamijouybari M, Heydari K, Maleki I, et al. Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship with Disease Prognosis. Caspian J Intern Med. 2020;11(Suppl 1):531-5. https://doi.org/10.22088/cjim.11.0.531.
  12. Şımşek AT, Karaarslan N, Gürbüz MS., Aladdam M, Çıne HŞ. Investigation of the Usability of Neutrophil/Lymphocyte Ratio as an Inflammation Marker in Pediatric Patients with Shunt Infection.https://doi.org/0.5137/1019-5157.TND.3506
  13. Özcanlı Çay Ö, Kemer, Ö. Prognostic evaluation of newborns with neonatal hyperbilirubinemia. J Med Palliat Care. 2023;4(6):690-3. https://doi.org/10.47582/jompac.1398442.
  14. Edvinsson L, Haanes KA, Warfvinge K. Does inflammation have a role in migraine?. Nat Rev Neurol. 2019;15(8):483-90. https://doi.org/10.1038/s41582-019-0216-y
  15. Polat İ, Karaoğlu P, Şişman AR, Yiş U, Hız Kurul S. Inflammation and endothelial dysfunction in pediatric migraine patients. Pediatr Int. 2022;64(1):e14946. https://doi.org/10.1111/ped.14946
  16. Cseh A, Farkas KM, Derzbach L, et al. Lymphocyte subsets in pediatric migraine. Neurol Sci. 2013;34(7):1151-5. https://doi.org/10.1007/s10072-012-1218-3
  17. Şahin S, Diler Durgut B, Dilber B,et al. Increased Hemoglobin and Plateletcrit Levels Indicating Hemoconcentration in Pediatric Patients with Migraine. J Pediatr Neurosci. 2020;15(2):99-104. https://doi.org/10.4103/jpn.JPN_73_19.
  18. Ertekin A. Diagnostic value of red blood cell indices and peripheral inflammatory markers in migraine patients during the interictal period. Neurology Asia. 2026;31(1):247–55. https://doi.org/10.54029/2026xru.
  19. Wu J, Fu L, Deng Z, et al. A study of changes in hematologic parameters in patients with migraine. Clin Exp Immunol. 2025;219 (1):uxae113. https://doi.org/10.1093/cei/uxae113
  20. Benedick A, Zeharia A, Markus TE. Comparison of Thrombocyte Count Between Pediatric Patients With Migraine or Tension-Type Headache: A Retrospective Cohort Study. J Child Neurol. 2019;34(13):824-9. https://doi.org/10.1177/0883073819862738
  21. Zeller JA, Lindner V, Frahm K, Baron R, Deuschl G. Platelet activation and platelet-leucocyte interaction in patients with migraine. Subtype differences and influence of triptans. Cephalalgia. 2005;25(7):536-41. https://doi.org/10.1111/j.1468-2982.2005.00916.x
  22. Ozge A, Saşmaz T, Buğdaycı R, et al. The prevalence of chronic and episodic migraine in children and adolescents. Eur J Neurol. 2013;20(1):95-101. https://doi.org/10.1111/j.1468-1331.2012.03795.x
  23. Asuncion RMD, Al Khalili Y, Chopra P. Migraine Headache in Childhood. In: StatPearls. Treasure Island (FL): StatPearls Publishing; March 4, 2023.
  24. Barnes N, Millman G, James E. Migraine headache in children. Clin Evid. 2006;(15):469-75.
  25. Pluncevic Gligoroska J, Gontarev S, Dejanova B, Todorovska L, Shukova Stojmanova D, Manchevska S. Red Blood Cell Variables in Children and Adolescents regarding the Age and Sex. Iran J Public Health. 2019;48(4):704-12.
  26. Ayça, Senem; Ayta, Semih. Platelet-to-lymphocyte ratio as a predictor to differentiate between childhood migraine and tension-type headache. Journal of Pediatric Neurosciences 18(1):40-3. January-March 2023. https://doi.org/10.4103/jpn.JPN_162_21
  27. Oskoui M, Pringsheim T, Holler-Managan Y, et al. Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019;93(11):487-99. https://doi.org/10.1212/WNL.0000000000008095
  28. Moosmann J, Krusemark A, Dittrich S, et al. Age- and sex-specific pediatric reference intervals for neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio. Int J Lab Hematol. 2022;44(2):296-301. https://doi.org/10.1111/ijlh.13768
  29. Yazar HO, Yazar T, Aygün A, Kaygisiz Ş, Kirbaş D. Evaluation of simple inflammatory blood parameters in patients with migraine. Ir J Med Sci. 2020;189(2):677-83. https://doi.org/10.1007/s11845-019-02136-y
  30. Hoppu K, Nergårdh AR, Eriksson AS, Beck O, Forssblad E, Boréus LO. Flunarizine of limited value in children with intractable epilepsy.Pediatr Neurol. 1995;13(2):143-7. https://doi.org/10.1016/0887-8994(95)00142-3
  31. Zhu J, Chen J, Zhang K. Clinical effect of flunarizine combined with duloxetine in the treatment of chronic migraine comorbidity of depression and anxiety disorder. Brain Behav. 2022;12(8):e2689. https://doi.org/10.1002/brb3.2689

Telif hakkı ve lisans

Telif hakkı © 2026 Yazar(lar). Açık erişimli bu makale, orijinal çalışmaya uygun şekilde atıfta bulunulması koşuluyla, herhangi bir ortamda veya formatta sınırsız kullanım, dağıtım ve çoğaltmaya izin veren Creative Commons Atıf Lisansı (CC BY) altında dağıtılmıştır.

Nasıl atıf yapılır

1.
Kemer Aycan Ö, Aydın H, Korkut O. Hematological markers of systemic inflammation potentially associated with migraine in pediatric patients. Turk J Pediatr Dis. 2026;Early View:1-7. https://doi.org/10.12956/TJPD.2026.1314