The Significance of High-Density Lipoprotein-Derived Inflammatory Parameters in Atypical Parkinsonisms—Pilot Study

<b>Background/Objectives:</b> Atypical parkinsonisms are a group of diseases with significant obstacles in the context of efficient methods of examination and understanding pathomechanisms. This is associated with the overlaps in clinical manifestation. One of the hypotheses regarding the mechanism leading to neurodegeneration in this group is related to inflammation. <b>Methods:</b> Authors examined 18 patients with Multiple System Atrophy-Parkinsonism Predominant (MSA-P), 15 with Progressive Supranuclear Palsy-Richardson's Syndrome (PSP-RS) and 15 with PSP-Parkinsonism Predominant (PSP-P) (disease duration: 3-6 years) using neutrophil-to-lymphocyte-ratio, platelet-to-lymphocyte ratio and high-density lipoprotein (HDL)-derived inflammatory ratios, e.g., neutrophil to high-density lipoprotein cholesterol ratio (NHR), lymphocyte to high-density lipoprotein cholesterol ratio (LHR) and platelet to high-density lipoprotein cholesterol ratio (PHR). The potential differences between the groups were examined using one-way ANOVA, with Tukey's HSD test. <b>Results</b>: The comparison revealed significant differences between PSP-RS and MSA-P in NHR (<i>p</i> = 0.0224). The levels of the parameters were more increased in MSA-P. No other significant differences were found. <b>Conclusions:</b> The possible significance of HDL in the context of brain-blood barrier permeability is a repeatedly highlighted feature of neurodegenerative diseases. The outcome of this pilot study may suggest that the evaluation of inflammatory processes should be performed with the indication of subtypes of PSP, as the character of pathomechanisms likely differs.