Association Between Serum Inflammatory Biomarkers and Disease Severity in Motor Neuron Disease

Open Access

Abstract

Background: Motor neuron disease (MND) progression is increasingly linked to systemic neuroinflammation, yet comprehensive data on conventional inflammatory markers within South Asian populations remains limited. This study evaluated the relationship between serum inflammatory biomarkers and functional disease severity in a Bangladeshi MND cohort. Methods & Materials: A hospital-based cross-sectional study was conducted with 80 adult MND patients. Functional severity was classified as mild, moderate, or severe using the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R). The study analyzed serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), erythrocyte sedimentation rate (ESR), neutrophil-to-lymphocyte ratio (NLR), and albumin. Multivariable logistic regression was utilized to identify independent predictors of severe disease while adjusting for demographic and clinical variables. Results: The cohort had a mean age of 55.8 ± 10.7 years, with 58.8% being male. Serum concentrations of CRP, IL-6, TNF-α, ESR, and NLR showed a significant progressive increase as disease severity worsened (all p < 0.001). Conversely, serum albumin significantly decreased with escalating disease severity (p = 0.002). All measured inflammatory markers exhibited significant inverse correlations with ALSFRS-R scores, with IL-6 showing the strongest correlation (r = -0.58, p < 0.001). Multivariable analysis confirmed that higher levels of CRP, IL-6, TNF-α, and NLR were independently associated with increased odds of severe MND, whereas serum albumin lost its independent predictive significance. Conclusion: Elevated systemic inflammatory biomarkers are strongly correlated with increased functional severity in MND. CRP, IL-6, TNF-α, and NLR serve as independent predictors of severe illness, underscoring the role of systemic immune activation and highlighting their potential as accessible, low-cost markers for disease monitoring and prognostication.