Blood Neutrophil-to-Lymphocyte Ratio as a Predictor of Cerebral Small-Vessel Disease

Abstract

Background In recent studies, neutrophil-to-lymphocyte ratio (NLR) was reported to be a good predictor of acute ischemic stroke (AIS), but its role in cerebral small-vessel disease (CSVD) is still controversial. We aimed to explore the value of NLR to identify CSVD. Material/Methods We enrolled 466 CSVD patients and 413 controls. The total burden score of CSVD was calculated according to MRI results, and imaging subgroups were divided according to MRI. The 90-day outcome was evaluated using the modified Rankin scale (mRS). NIHSS score, mRS, clinical information, biochemical parameters, and NLR were recorded, and we analyzed the relationship between NLR and CSVD. Results NLR was a risk factor for CSVD (OR 1.58, 95%CI 1.015~1.322; P =0.029). NLR was positively correlated with CSVD (r=0.259; P =0.001). The AUC was 0.774, with a cut-off value of 1.89 (95% CI 0.742~0.806), P =0.000. NLR was significantly different among the different total burden score groups of CSVD ( P =0.009). NLRs were significant different among enlarged perivascular space (EPVS) groups ( P =0.017), periventricular white matter high signal (PWMHS) groups ( P =0.028), and deep white matter high signal (DWMHS) groups ( P =0.004), but no significant difference was found among cerebral microbleeds (CMBs) groups ( P =0.118). NLR was correlated with short-term outcome of CSVD ( P =0.000). The AUC was 0.732 (95% CI 0.684~0.779), with a cut-off value of 2.413 for predicting a poor CSVD prognosis. Conclusions NLR has potential diagnostic value for CSVD, and it can predict the short-term outcome of CSVD. Therefore, NLR may be a useful biomarker to predict CSVD and its outcome.

Correlation between neutrophil/lymphocyte ratio and cognitive impairment in cerebral small vessel disease patients: A retrospective study

“…Besides, it is more stable for measurement and less affected by conditions that could change the individual cell counts (19). Compared with conventional inflammatory markers summarized in a review (13), there are only a few studies on the relationship between NLR and CSVD (20)(21)(22)(23)(24).…”

Biomarkers involved in the pathogenesis of cerebral small-vessel disease

“…High levels of CRP and PCT have been reported to be associated with EPVS ( 22 , 47 , 48 ), and plasma HCY level was correlated with EPVS in basal ganglia ( 49 ). There is also a significant association between neutrophil count and EPVS in basal ganglia in a community-based study ( 50 ), neutrophil-to-lymphocyte ratio (NLR), and EPVS in a patient study ( 51 ). Furthermore, serum cortisol levels were found to be independent predictors of moderate-to-severe EPVS and cognitive dysfunction ( 52 ).…”