Global, regional, and national burden of headache disorders, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
Masayuki Teramoto, Yvonne Yiru Xu, Jaimie D Steinmetz, Mohammad Amin Aalipour, Hasan Aalruz, Deldar Morad Abdulah, Richard Gyan Aboagye, Dariush Abtahi, Samir Abu Rumeileh, Salahdein Aburuz, Qorinah Estiningtyas Sakilah Adnani, Obed Adonteng-Kissi, Giuseppina Affinito, Danish Ahmad, Negar Sadat Ahmadi, Ali Ahmed, Asma Ahmed, Shahzaib Ahmed, Mohammad Ahmmad Mahmoud Al Zoubi, Sawsan Alabbad, Yazan Al-Ajlouni, Mohammed Albashtawy, Fadwa Naji Alhalaiqa, Ashraf Alhumaidi, Mohammed Usman Ali, Syed Shujait Ali, Montaha Al-Iede, Joseph Uy Almazan, Najim Z Alshahrani, Awais Altaf, Mohammad Al-Wardat, Yaser Mohammed Al-Worafi, Karem H Alzoubi, Sohrab Amiri, Ganiyu Adeniyi Amusa, David B Anderson, Abhishek Anil, Jalal Arabloo, Aleksandr Y Aravkin, Demelash Areda, Mahsa Asadi Anar, Mohammad Asghari-Jafarabadi, Sait Ashina, Khursheed Aurangzeb, Arian Azadnia, Ahmed Y Azzam, Youngoh Bae, Razieh Bahreini, Soham Bandyopadhyay, Hiba Jawdat Barqawi, Azadeh Bashiri, Rehana Basri, Mohammad-Mahdi Bastan, Jina Behjati, Maryam Bemanalizadeh, Jeetendra Bhandari, Sonu Bhaskar, Gurjit Kaur Bhatti, Jasvinder Singh Bhatti, Rajbir Bhatti, Bijit Biswas, Bruno Bizzozero-Peroni, Archith Boloor, Meriem Boukhiam, Yasser Bustanji, Sanjay C J, Luis Alberto Cámera, Edoardo Caronna, Ana Paula Carvalho-e-Silva, Sandip Chakraborty, Vijay Kumar Chattu, Anis Ahmad Chaudhary, Patrick R Ching, Hongyuan Chu, Josielli Comachio, Daniela Contreras, Natalia Cruz-Martins, Omid Dadras, Xiaochen Dai, Emanuele D'Amico, Anh Kim Dang, Lucio D'Anna, Sindhura Deekonda, Pouria Delbari, Andreas K Demetriades, Emina Derviševic, Vinoth Gnana Chellaiyan Devanbu, Amol S Dhane, Bibha Dhungel, Xueting Ding, Huyen Phuc Do, Ojas Prakashbhai Doshi, Siddhartha Dutta, Lamiaa Labieb Mahmoud Ebraheim, Ebrahim Eini, Michael Ekholuenetale, Sharareh Eskandarieh, Andre Faro, Valery L Feigin, Gelana Fekadu
Abstract
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 estimates health loss from migraine, tension-type headache, and medication-overuse headache. This study presents updated results on headache-attributed burden from 1990 to 2023, along with clinical and public health implications. METHODS: Data on the prevalence, incidence, or remission of migraine, tension-type headache, and medication-overuse headache were extracted from published population-based studies. We used hierarchical Bayesian meta-regression modelling to estimate global, regional, and country-level prevalence of headache disorders. For the first time in GBD 2023, age-specific and sex-specific estimates of time in symptomatic state were applied by meta-analysing individual participant data from 41 653 individuals from the general populations of 18 countries from all parts of the world. Disability weights were applied to calculate years lived with disability (YLDs). Since medication-overuse headache is a sequela of a mistreated primary headache (due to medication overuse), its burden was reattributed to migraine or tension-type headache, informed by a meta-analysis of three longitudinal studies. FINDINGS: In 2023, 2·9 billion individuals (95% uncertainty interval 2·6-3·1) were affected by headache disorders, with a global age-standardised prevalence of 34·6% (31·6-37·5) and a YLD rate of 541·9 (373·4-739·9) per 100 000 population, with 487·5 (323·0-678·8) per 100 000 population attributed to migraine. The prevalence rates of these headache disorders have remained stable over the past three decades. YLD rates due to headache disorders were more than twice as high in females (739·9 [511·2-1011·5] per 100 000) as in males (346·1 [240·4-481·8] per 100 000). Medication-overuse headache contributed 58·9% of the YLD estimates for tension-type headache in males and 56·1% in females, as well as 22·6% of the YLD estimates for migraines in males and 14·1% in females. INTERPRETATION: Headache disorders, in particular migraine, continue to be a major global health challenge, emphasising the need for effective management and prevention strategies. Much headache-attributed burden could be averted or eliminated by avoiding overuse of medication (including over-the-counter medication), underscoring the importance of public education. FUNDING: Gates Foundation.