Vitamin D concentrations and neutrophil-to-lymphocyte ratio are associated with disability and pain sensitivity in individuals with migraine: a cross-sectional study.

Abstract

This secondary analysis aimed to examine the associations between biochemical biomarkers, lipid profiles and clinical outcomes in individuals with migraine. A cross-sectional study including 72 adults with a confirmed migraine diagnosis according to the ICHD-III criteria was conducted. Clinical outcomes comprised pressure pain thresholds (PPTs) at trigeminal and extratrigeminal sites, migraine-related disability (MIDAS), perceived stress (PSS-14), and handgrip strength. Biochemical parameters included serum vitamin D concentrations, the (Neutrophil-to-Lymphocyte Ratio (NLR), lipid profile and fasting glucose. Independent associations were assessed using adjusted multiple linear regression models. Higher NLR was associated with greater migraine-related disability (MIDAS; r = 0.38, p < .05) and higher perceived stress (PSS-14; r = 0.43, p < .05). Vitamin D concentrations were significantly and positively correlated with higher PPTs, particularly at the anterior temporalis (r = 0.36, p < .05), middle temporalis (r = 0.24, p < .05), and sternocleidomastoid muscles (r = 0.28, p < .05). Regression models further showed that elevated NLR was linked to increased disability (B = -0.35, 95% CI -0.47 to -0.17, p = .001) and lower PPTs at masseter (B = -0.40, 95% CI -0.75 to -0.14, p = .01) and middle temporalis (B = -0.34, 95% CI -0.46 to -0.13, p = .009). Also, lower vitamin D concentrations were associated with decreased PPTs at the middle temporalis (B = -0.38, 95% CI -0.52 to -0.22, p = .001). Higher NLR, as a marker of systemic inflammation, was associated with greater migraine-related disability and increased pain sensitivity, whereas lower vitamin D concentrations were associated with increased pain sensitivity.