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BackgroundThis study investigates the association between systemic inflammatory indices-specifically, the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI)-and the severity of cerebral small vessel disease (CSVD) in patients with Parkinson's disease (PD).MethodsA total of 167 patients with primary PD and complete MRI data were included. CSVD severity was assessed using total and modified CSVD burden scores, with patients categorized into two groups: mild (scores 0-1 or 0-2) and moderate-severe (scores 2-4 or 3-6). Logistic and ROC analyses were employed to evaluate the association and discriminative ability of SII and SIRI for CSVD severity.ResultsAmong 167 patients (59.3% male, mean age 69.6 ± 8.7 years), 91 and 96 were classified with moderate-severe CSVD based on total and modified scores, respectively. Higher SII and SIRI levels, along with a greater proportion of hypertension, were observed in the moderate-severe CSVD group. Spearman analysis indicated SII weakly correlated with both CSVD scores (total: r = 0.224, p = 0.004; modified: r = 0.155, p = 0.046), while SIRI showed a weak correlation with the total score only (r = 0.179, p = 0.021). After adjusting for covariates, logistic regression showed the highest tertiles of SII and SIRI were significantly associated with moderate-severe CSVD, whether using the total score (T3 vs. T1: OR 2.919, 95% CI 1.191-7.153 for SII; OR 4.295, 95% CI 1.681-10.973 for SIRI) or the modified score (T3 vs. T1: OR 4.196, 95% CI 1.705-10.327 for SII; OR 3.303, 95% CI 1.326-8.226 for SIRI).ConclusionAlthough their individual discriminatory abilities are limited, elevated SII and SIRI are independently associated with more severe CSVD in PD patients.
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