OC-20 | The inflammatory burden index in pediatric migraine: a clinical study

Carola Meo¹, Giulia Manfrè¹, Antonella Morea², Caterina Gaspari¹, Martina Tarantini², Maria Rosita Ruta³, Sofia D’Agostino¹, Edvige Correnti⁴, Daniela D’Agnano², Diletta Lopes⁴, Rosaria Nardello¹, Giuseppe Santangelo⁴, Vittorio Sciruicchio², Vincenzo Raieli⁴ | ¹Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo; ²Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari; ³Child Neuropsychiatry Unit, ASP 6 Palermo; ⁴Child Neuropsychiatry Department, ISMEP, ARNAS Civico, Palermo, Italy

Background: Systemic inflammation, particularly neuroinflammation, is increasingly recognized as a contributing factor in the pathophysiology of migraine. The Inflammatory Burden Index (IBI)—calculated as the product of neutrophils and CRP divided by lymphocytes—is an emerging integrated inflammatory biomarker. IBI has been recently employed in oncology, cardiovascular diseases, and autoimmune disorders to assess systemic inflammatory load and predict clinical outcomes. This study aimed to compare IBI levels in children and adolescents diagnosed with migraine, idiopathic epilepsy, and a control group with non-inflammatory conditions, in order to explore the role of inflammation in pediatric migraine

Methods: Sixty patients aged 6–18 years were recruited from the Child Neuropsychiatry Units in Palermo and Bari and divided into three groups: migraine (n=20), idiopathic epilepsy (n=20), and controls (n=20). IBI values were calculated and compared across groups using ANOVA. Independent t-tests were used to assess sex differences within the migraine group and between migraine and non-migraine subjects.

Results: Mean IBI was significantly higher in migraine patients (1.49 ± 2.11) compared to both the epilepsy group (0.82 ± 1.03) and healthy controls (0.60 ± 1.28) (p=0.034). Although patients with epilepsy showed a trend toward elevated IBI compared to controls, the difference was not statistically significant (p=0.11). No significant sex differences in IBI were observed within the migraine group (p=0.78). However, both male (p=0.045) and female (p=0.015) migraine patients had significantly higher IBI levels compared to their non-migraine peers.

Conclusion: The elevation of IBI in children and adolescents with migraine supports a role for systemic and neuroinflammation in the disease’s pathogenesis. IBI may serve as a promising biomarker for risk stratification, early diagnosis, and therapeutic monitoring, fostering a personalized approach to the management of pediatric migraine.