review · The Lancet Neurology
This study provides updated estimates of the global health burden caused by migraine, tension-type headache, and medication-overuse headache from 1990 to 2023. Researchers used hierarchical Bayesian meta-regression modelling and, for the first time, incorporated age- and sex-specific data from over 41,000 individuals across 18 countries to estimate years lived with disability (YLDs). The burden of medication-overuse headache was reattributed to primary headache types. Findings indicate that in 2023, 2.9 billion people were affected by headache disorders, with a global age-standardised prevalence of 34.6%. The prevalence has remained stable for three decades, and YLD rates were more than twice as high in females. Medication overuse significantly contributed to the YLDs for both tension-type headache and migraine, highlighting the need for effective management and prevention strategies.
This research highlights the immense global burden of headache disorders, particularly migraine, affecting billions of people. It underscores the critical need for better prevention and management strategies, including public education on avoiding medication overuse, to significantly reduce suffering and disability worldwide.
The abstract indicates a need for effective management and prevention strategies for headache disorders. This suggests potential for new or improved diagnostic tools, therapeutic interventions, or public health programmes aimed at reducing medication overuse. Such developments would be early-stage research or applied research, targeting healthcare providers, pharmaceutical companies, and public health organisations.
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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.
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DOI: 10.1016/s1474-4422(25)00402-8
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