Objective: Chronic migraine (CM) is a disabling neurovascular disorder often linked to systemic low-grade inflammation. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been proposed as an integrative biomarker of nutritional and inflammatory status; however, its role in migraine remains unclear. This study examined whether HALP improves after interventional therapy in treatment-resistant CM and whether changes correlate with clinical outcomes.
Materials and
Methods: This retrospective study included 128 CM patients who were unresponsive to ≥3 months of pharmacological prophylaxis and subsequently achieved a ≥50% reduction in monthly headache frequency after interventional treatment were analyzed. Patients received either repetitive greater occipital nerve blocks or pulsed radiofrequency. Clinical outcomes (headache frequency, numerical rating scale (NRS), and analgesic consumption) and laboratory parameters (hemoglobin, albumin, lymphocyte, and platelet counts) were recorded at baseline and 6 months. HALP was calculated as (Hemoglobin (g/L) × Albumin (g/L) × Lymphocyte count (×10⁹/L) / Platelet count (×10⁹/L)). Associations were tested with Spearman’s ρ.

Results: At 6 months, patients showed significant improvements: NRS decreased from 8.0 (7.0–9.0) to 3.0 (3.0–4.0), headache frequency from 19.0 (16.8–21.0) to 3.0 (2.0–4.0), and analgesic consumption from 8.0 (6.0–9.0) to 3.0 (2.0–4.0) tablets/month (all p<0.001). HALP increased from 49.3 (36.2–58.4) to 66.5 (56.0–75.7) (p<0.001). ΔHALP was weakly but statistically significantly correlated with reduced headache frequency (ρ=0.195, p=0.027), but not with ΔNRS (ρ=0.091, p=0.308) or Δanalgesic consumption (ρ=0.103, p=0.246).

Conclusion: Interventional treatments for CM were associated with significant increases in HALP scores, suggesting modulation of systemic inflammatory–nutritional status. As ΔHALP was only weakly related to reduced attack frequency and unrelated to pain intensity or analgesic use, HALP may reflect biological changes at the group level and could serve as a monitoring biomarker; however, its individual-level clinical relevance appears to be limited.