Objective: To investigate the peripheral inflammatory markers distinguishing Parkinson’s disease (PD) or Parkinson plus syndrome (PPS).

Background: Previous studies had suggested that peripheral inflammation may play an important role as well as inflammation of the central nervous system in the pathogenesis of PD. There were variable indicators reflecting peripheral inflammatory condition: white blood cells (WBCs), neutrophils, lymphocytes, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Also, neutrophil to lymphocyte ratio (NLR), representing the active inflammation (neutrophils) merged with immunological regulatory processes (lymphocytes), was newly considered a valid marker related to peripheral inflammation in PD.

Method: For this study, clinical and serologic data from 225 patients was collected consecutively, who was diagnosed as drug-naïve PD, PPS, and controls. PPS included multiple system atrophy, progressive supranuclear palsy, corticobasal syndrome, and dementia with lewy bodies. Drug-induced parkinsonism or essential tremor with normal dopamine transporter image, were used as controls. Patients who had conditions like an infectious disease which can influence inflammation were excluded.

Results: Overall, 87 patients with PD, 71 patients with PPS, and 60 controls were enrolled. NLR did not show a significant difference between PD and controls (p = 0.18), while NLR was significantly higher in patients with PPS than in patients with PD (p = 0.014). Also, NLR showed a positive correlation with UPDRS part III score in PD. (r = 0.284, p = 0.008). However, there were no differences between the three groups in WBCs, ESR, and CRP (p > 0.05).

Conclusion: Increased NLR could be a marker distinguishing PPS from PD, or reflecting disease severity

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MDS Abstracts - https://www.mdsabstracts.org/abstract/increased-neutrophil-to-lymphocyte-ratio-distinguish-parkinsons-disease-and-parkinson-plus-syndrome/