Association Between Neutrophil-to-Lymphocyte Ratio and Cardiac Sympathetic Denervation in Parkinson's Disease
- 1Division of Neurology and Gerontology, Department of Internal Medicine, Iwate Medical University
Abstract
BackgroundPeripheral inflammation has been implicated in the pathophysiology of Parkinsons disease (PD), but its relationship wth autonomic dysfunction remains unclear.
ObjectivesTo explore the association between peripheral inflammation, assessed by the neutrophil-to-lymphocyte ratio (NLR), and autonomic function in patients with PD.
MethodsWe retrospectively analyzed 97 patients with PD who underwent 123I-metaiodobenzylguanidine (MIBG) cardiac scintigraphy and differential blood cell counts. Associations of NLR with early and delayed heart-to-mediastinum (H/M) ratios, washout ratio, and the coefficient of variation of R-R intervals (CVRR) were assessed using Spearmans rank correlation and multivariable linear regression adjusted for age, sex, and disease duration.
ResultsNo significant univariable correlations were observed between NLR and the autonomic measures. In multivariable analysis, higher NLR was associated with a lower early H/M ratio (B = -0.802, 95% CI -1.598 to -0.005, P = 0.049), whereas no significant associations were observed with the delayed H/M ratio, washout ratio, or CVRR. Sensitivity analyses showed a generally consistent direction of association, although the effect estimate was attenuated after exclusion of two influential observations and statistical significance was not consistently retained.
ConclusionsHigher NLR was associated with lower early cardiac MIBG uptake after adjustment for age, sex, and disease duration in patients with PD. This exploratory finding raises the possibility of an association between systemic inflammation and sympathetic dysfunction in PD and requires confirmation in larger prospective studies.
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BibTeX
@misc{takahashi2026association,
title = {{Association Between Neutrophil-to-Lymphocyte Ratio and Cardiac Sympathetic Denervation in Parkinson's Disease}},
author = {M. Takahashi and K. Yoshino and R. Nozaki and T. Yamaguchi and K. Taguchi and Y. Suzuki and K. Takahashi and K. Takahashi and K. Iwaoka and T. Maeda},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.18.26365787},
url = {https://www.medrxiv.org/content/10.64898/2026.10.18.26365787v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Association Between Neutrophil-to-Lymphocyte Ratio and Cardiac Sympathetic Denervation in Parkinson's Disease
AU - M. Takahashi
AU - K. Yoshino
AU - R. Nozaki
AU - T. Yamaguchi
AU - K. Taguchi
AU - Y. Suzuki
AU - K. Takahashi
AU - K. Takahashi
AU - K. Iwaoka
AU - T. Maeda
PY - 2026
DA - 2026/10/18
PB - medRxiv
DO - 10.64898/2026.10.18.26365787
UR - https://www.medrxiv.org/content/10.64898/2026.10.18.26365787v1
AB - BackgroundPeripheral inflammation has been implicated in the pathophysiology of Parkinsons disease (PD), but its relationship wth autonomic dysfunction remains unclear. ObjectivesTo explore the association between peripheral inflammation, assessed by the neutrophil-to-lymphocyte ratio (NLR), and autonomic function in patients with PD. MethodsWe retrospectively analyzed 97 patients with PD who underwent 123I-metaiodobenzylguanidine (MIBG) cardiac scintigraphy and differential blood cell counts. Associations of NLR with early and delayed heart-to-mediastinum (H/M) ratios, washout ratio, and the coefficient of variation of R-R intervals (CVRR) were assessed using Spearmans rank correlation and multivariable linear regression adjusted for age, sex, and disease duration. ResultsNo significant univariable correlations were observed between NLR and the autonomic measures. In multivariable analysis, higher NLR was associated with a lower early H/M ratio (B = -0.802, 95% CI -1.598 to -0.005, P = 0.049), whereas no significant associations were observed with the delayed H/M ratio, washout ratio, or CVRR. Sensitivity analyses showed a generally consistent direction of association, although the effect estimate was attenuated after exclusion of two influential observations and statistical significance was not consistently retained. ConclusionsHigher NLR was associated with lower early cardiac MIBG uptake after adjustment for age, sex, and disease duration in patients with PD. This exploratory finding raises the possibility of an association between systemic inflammation and sympathetic dysfunction in PD and requires confirmation in larger prospective studies.
ER -