Hematological Parameters and Inflammation in Primary Headache Types: A Retrospective Study of Migraine and Chronic Tension-Type Headache

BACKGROUND/AIMS: Headache disorders, particularly migraine and chronic tension-type headache (CTTH), are highly prevalent neurological conditions contributing substantially to global disability.Hematologic and inflammatory markers have been proposed as potential indicators of migraine, yet findings remain inconsistent.This study aimed to examine sex-, age-, and subtype-specific differences in hematologic and inflammatory indices among patients with migraine and CTTH, and healthy controls. MATERIALS AND METHODS:We conducted a retrospective cross-sectional case-control study in the neurology outpatient clinic between December 2024 and March 2025.Medical records and same-day laboratory results for patients diagnosed with migraine (chronic or episodic) or with CTTH were reviewed.Participants were classified according to the International Classification of Headache Disorders, 3 rd edition criteria.Complete blood counts were used to calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and composite indices, including red cell distribution width to mean corpuscular volume ratio (RDW/MCV), platelet distribution width to platelet count ratio, and hemoglobin (Hb) to RDW ratio. RESULTS:A total of 1,074 participants were included in the study.Compared with CTTH and controls, migraine patients had lower Hb and hematocrit levels, and higher RDW, NLR, and PLR values (all p<0.01).In the migraine subgroup analysis, patients with aura had lower lymphocyte counts and higher NLR compared with those without aura (p<0.001).Patients with chronic migraine had higher platelet counts and higher Migraine Disability Assessment scores (38.5 vs. 16; p<0.001). CONCLUSION:Migraine is associated with modest but consistent alterations in hematologic and inflammatory markers, particularly elevated RDW and NLR, supporting systemic immune-vascular involvement and the potential of these markers as adjunctive biomarkers.