# Neutrophil-to-Lymphocyte Ratio as a Biomarker for Motor Subtypes in Idiopathic Parkinson’s Disease

## TL;DR

This study shows that the neutrophil-to-lymphocyte ratio (NLR) can help distinguish between motor subtypes of Parkinson’s disease.

## Contribution

The study identifies NLR as a novel potential biomarker for differentiating motor subtypes in idiopathic Parkinson’s disease.

## Key findings

- NLR was significantly higher in the PIGD subtype compared to the TD subtype.
- PIGD subtype showed greater disease severity as measured by the Hoehn and Yahr scale.
- No significant differences were found in age, sex, or disease duration between the two subtypes.

## Abstract

Background: Parkinson’s disease (PD) is one of the most common neurodegenerative disorders, primarily affecting movement and motor function. Described by the symptoms, including tremors, rigidity, bradykinesia, and postural instability, PD presents clinical heterogeneity in patients, which complicates diagnostic and therapeutic interventions.

Objective: The study aimed to find the neutrophil-to-lymphocyte ratio (NLR) as a biomarker for motor subtypes in idiopathic PD.

Materials and methods: This prospective observational study was conducted at Chiniot General Hospital Karachi, Pakistan, from January 2023 to January 2024. Data were collected from 55 patients suffering from idiopathic PD. Demographic and clinical data were collected for each patient, including age, sex, disease duration, and medications used for PD management.

Results: There was no significant difference between the tremor-dominant (TD) and postural instability and gait difficulty (PIGD) subtypes in terms of age (p = 0.45), sex distribution (p = 0.62), or disease duration (p = 0.68). However, the Hoehn and Yahr scale, which measures disease severity, was significantly higher in the PIGD subtype (2.9 ± 0.6) compared to the TD subtype (2.4 ± 0.5) with a p-value of 0.03, indicating greater disease severity in the PIGD group. The results indicate that the NLR was significantly higher in the PIGD subtype (3.17 ± 0.89) than in the TD subtype (2.41 ± 0.72), with a p-value of 0.01. This suggests a stronger inflammatory response in the PIGD subtype, which could be linked to greater disease severity in these patients.

Conclusion: The NLR can be a potential biomarker for distinguishing motor subtypes in idiopathic PD.