.: ORİJİNAL ARAŞTIRMA
The Role of Inflammatory Markers in Predicting the Effectiveness of Greater Occipital Nerve Block in Chronic Migraine: Retrospective Cohort Study
Kronik Migrende Büyük Oksipital Sinir Bloğunun Etkinliğini Öngörmede İnflamatuar Belirteçlerin Rolü: Retrospektif Kohort Çalışması
Turkiye Klinikleri J Anest Reanim. 2025;23(2):68-73
doi: 10.5336/anesthe.2025-112719
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: This study was aimed to evaluate whether systemic inflammatory markers-specifically the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)-could serve as reliable predictors in determining the clinical efficacy of greater occipital nerve (GON) block treatment among patients suffering from chronic migraine. Material and Methods: This retrospective cohort study included 48 adult patients who had been diagnosed with and who underwent GON block therapy between 2020 and 2025. Each patient received a standardized protocol consisting of seven GON block interventions. The therapeutic response was defined as a reduction of ≥50% in the number of monthly headache days compared to baseline. Demographics and inflammatory indices were derived from the complete blood count (NLR, SII, SIRI, and AISI) were collected and analyzed. The cohort was then divided into responders and non-responders based on clinical outcome. Results: A favorable treatment response was observed in 33 (68.7%). No statistically significant differences were found in baseline demographic variables, between the responder and non-responder groups. Similarly, none of the inflammatory markers-NLR, SII, SIRI, and AISI-showed significant differences between the 2 groups (p>0.05). Conclusion: The findings of this study suggest that systemic inflammatory markers such as NLR, SII, SIRI, and AISI don't have a significant predictive value in assessing the response to GON block in patients with chronic migraine.
Keywords: Migraine disorders; nerve block; chronic pain; inflammation; biomarkers
Objective: This study was aimed to evaluate whether systemic inflammatory markers-specifically the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)-could serve as reliable predictors in determining the clinical efficacy of greater occipital nerve (GON) block treatment among patients suffering from chronic migraine. Material and Methods: This retrospective cohort study included 48 adult patients who had been diagnosed with and who underwent GON block therapy between 2020 and 2025. Each patient received a standardized protocol consisting of seven GON block interventions. The therapeutic response was defined as a reduction of ≥50% in the number of monthly headache days compared to baseline. Demographics and inflammatory indices were derived from the complete blood count (NLR, SII, SIRI, and AISI) were collected and analyzed. The cohort was then divided into responders and non-responders based on clinical outcome. Results: A favorable treatment response was observed in 33 (68.7%). No statistically significant differences were found in baseline demographic variables, between the responder and non-responder groups. Similarly, none of the inflammatory markers-NLR, SII, SIRI, and AISI-showed significant differences between the 2 groups (p>0.05). Conclusion: The findings of this study suggest that systemic inflammatory markers such as NLR, SII, SIRI, and AISI don't have a significant predictive value in assessing the response to GON block in patients with chronic migraine.
Keywords: Migraine disorders; nerve block; chronic pain; inflammation; biomarkers
ÖZET
Amaç: Bu çalışma, kronik migren tedavisinde büyük oksipital sinir [greater occipital nerve (GON)] blokajının etkinliğini öngörmede, sistemik inflamasyon göstergeleri olan nötrofil/lenfosit oranı [neutrophil-to-lymphocyte ratio (NLR)], sistemik immün-inflamasyon indeksi [systemic immune-inflammation index (SII)], sistemik inflamasyon yanıt indeksi [systemic inflammation response index (SIRI)] ve agregat sistemik inflamasyon indeksi [aggregate index of systemic inflammation (AISI)] değerlerinin prediktif rolünü araştırmayı amaçlamaktadır. Gereç ve Yöntemler: Bu retrospektif kohort çalışma, 2020-2025 yılları arasında kronik migren tanısıyla GON blokajı uygulanan 48 hastayı içermektedir. Tüm hastalara toplam 7 blok uygulanmış ve tedavi yanıtı, ayda baş ağrısı günlerinde %50 veya daha fazla azalma olarak tanımlanmıştır. Hastaların demografik verileri ve tam kan sayımı üzerinden hesaplanan inflamatuar parametreleri (NLR, SII, SIRI ve AISI) analiz edildi. Sonrasında hastalar klinik yanıta göre yanıtlılar ve yanıtsızlar olarak ayrıldı. Bulgular: Hastaların %68,7'si (n=33) tedaviye başarılı yanıt verdi. Yanıt veren ve vermeyen gruplar arasında yaş ve cinsiyeti içeren demografik veriler açısından anlamlı fark bulunmadı. NLR, SII, SIRI ve AISI değerleri açısından da yanıt veren ve vermeyen gruplar arasında istatistiksel fark yoktu (p˃0,05). Sonuç: NLR, SII, SIRI ve AISI gibi sistemik inflamasyon belirteçleri, GON blok tedavisine yanıtı öngörmede anlamlı bir fark göstermemiştir.
Anahtar Kelimeler: Migren hastalıkları; sinir bloğu; kronik ağrı; inflamasyon; biyobelirteçler
Amaç: Bu çalışma, kronik migren tedavisinde büyük oksipital sinir [greater occipital nerve (GON)] blokajının etkinliğini öngörmede, sistemik inflamasyon göstergeleri olan nötrofil/lenfosit oranı [neutrophil-to-lymphocyte ratio (NLR)], sistemik immün-inflamasyon indeksi [systemic immune-inflammation index (SII)], sistemik inflamasyon yanıt indeksi [systemic inflammation response index (SIRI)] ve agregat sistemik inflamasyon indeksi [aggregate index of systemic inflammation (AISI)] değerlerinin prediktif rolünü araştırmayı amaçlamaktadır. Gereç ve Yöntemler: Bu retrospektif kohort çalışma, 2020-2025 yılları arasında kronik migren tanısıyla GON blokajı uygulanan 48 hastayı içermektedir. Tüm hastalara toplam 7 blok uygulanmış ve tedavi yanıtı, ayda baş ağrısı günlerinde %50 veya daha fazla azalma olarak tanımlanmıştır. Hastaların demografik verileri ve tam kan sayımı üzerinden hesaplanan inflamatuar parametreleri (NLR, SII, SIRI ve AISI) analiz edildi. Sonrasında hastalar klinik yanıta göre yanıtlılar ve yanıtsızlar olarak ayrıldı. Bulgular: Hastaların %68,7'si (n=33) tedaviye başarılı yanıt verdi. Yanıt veren ve vermeyen gruplar arasında yaş ve cinsiyeti içeren demografik veriler açısından anlamlı fark bulunmadı. NLR, SII, SIRI ve AISI değerleri açısından da yanıt veren ve vermeyen gruplar arasında istatistiksel fark yoktu (p˃0,05). Sonuç: NLR, SII, SIRI ve AISI gibi sistemik inflamasyon belirteçleri, GON blok tedavisine yanıtı öngörmede anlamlı bir fark göstermemiştir.
Anahtar Kelimeler: Migren hastalıkları; sinir bloğu; kronik ağrı; inflamasyon; biyobelirteçler
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