Endothelial Activation and Stress Index (EASIX) in migraine: association with disease subtypes and clinical characteristics

BMC Neurol. 2026 May 13. doi: 10.1186/s12883-026-04959-6. Online ahead of print.

ABSTRACT

BACKGROUND: Migraine is a common neurovascular disorder associated with endothelial dysfunction and systemic microvascular stress. The Endothelial Activation and Stress Index (EASIX) is a novel composite biomarker that has been proposed to reflect endothelial stress and thrombo-inflammatory activity. This study aimed to investigate the association between EASIX levels and migraine subtypes and to explore its potential clinical relevance in patients with migraine with aura.

METHODS: This retrospective cross-sectional study included 66 patients with migraine with aura, 99 patients with migraine without aura, and 81 age- and sex-matched healthy controls. EASIX was calculated using the formula: (lactate dehydrogenase × creatinine) / platelet count. EASIX values were compared among the study groups. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminative ability of EASIX in distinguishing patients with migraine with aura and overall migraine patients from healthy controls. Univariate logistic regression analysis was conducted to evaluate the association between EASIX levels and migraine with aura.

RESULTS: Mean EASIX values were higher in patients with migraine with aura compared to healthy controls (p = 0.048). ROC analysis demonstrated that EASIX had a modest discriminative ability to differentiate patients with migraine with aura from healthy controls (AUC = 0.58). An optimal cut-off value of 0.37 yielded a sensitivity of 66.6% and specificity of 51.8%. Logistic regression analysis revealed that higher EASIX levels were significantly associated with migraine with aura (OR: 3.35, 95% CI: 1.45-7.74, p = 0.004).

CONCLUSIONS: EASIX levels were higher in patients with migraine with aura compared to healthy controls, suggesting a potential association between endothelial stress and this migraine subtype. However, its discriminative performance was limited, and EASIX should be considered as an exploratory biomarker rather than a diagnostic tool. Further prospective studies are warranted to clarify its clinical relevance.

PMID:42129672 | DOI:10.1186/s12883-026-04959-6