Global, regional, and national burden of migraine, 1990-2021: a systematic analysis from the global burden of disease study 2021

Background: Migraine is a prevalent and disabling neurovascular disorder that poses a significant public health challenge worldwide. Currently, there is a lack of comprehensive analysis regarding the global disease burden and evolving trends of migraine. Methods: Based on the latest data from the GBD 2021 study, we analyzed the incidence, prevalence, and disability-adjusted life years (DALYs) associated with migraines at global, regional, and national levels from 1990 to 2021. We analyzed the uneven distribution and changes in the global migraine disease burden. We conducted a stratified analysis of the data by age, sex, year, geographic region, and sociodemographic index (SDI). The Joinpoint model was employed to assess the trend of the migraine disease burden from 1990 to 2021, while the Norpred prediction model was utilized to forecast changes in migraine-related disease burden over the next 20 years. Furthermore, we performed a decomposition analysis to examine the factors contributing to changes in migraine disease burden from 1990 to 2021, specifically considering population aging, population growth, and shifts in epidemiological patterns. Results: From 1990 to 2021, the global age-standardized incidence, prevalence, and DALYs rates of migraine exhibited a slight upward trend. The total incidence number, prevalence number, and DALYs number of migraine have increased year by year, indicating a significant rise in the disease burden associated with migraine. For 32 years, the burden of migraine has been significantly higher in females than in males. It is noteworthy that in 2021, the growth rates of the age-standardized incidence rate, prevalence rate, and DALYs associated with male migraine were significantly higher than those observed for female migraine when compared to 1990. Over the past 32 years, adolescents aged 10-14 years have consistently represented the group with the highest incidence rate and incidence number of migraine. In both 1990 and 2021, the highest prevalence rate among the total population and females occurred in the 40-44 age group. In 1990, the highest prevalence among males was in the 30-34 age group, while in 2021, it shifted to the 35-39 age group. The highest value for migraine DALYs in both males and females in 1990 and 2021 remained in the 40-44 age group. The global distribution of migraine burden reveals significant regional and national differences, which are positively correlated with the SDI. While the age-standardized incidence rate of migraine is anticipated to decrease annually over the next 20 years, the absolute number of migraine cases is expected to continue increasing each year due to population growth. Population-based migraine DALY rates are projected to peak in 2029 before experiencing a subsequent annual decline. Conclusion: Over the past 32 years, the global burden of migraine has increased significantly, remaining a major contributor to the global burden of neurological disease. It is essential that males and females of all ages, particularly adolescents, have access to healthcare services to address the growing migraine population. Temporal trends in migraine incidence do not align with socioeconomic development and vary considerably between countries. Our study underscores the necessity for targeted public health interventions to address migraine, emphasizing the importance of considering the socioeconomic context when planning strategies to reduce the global burden of this condition.