Global, regional, and national burden of headache disorders, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Sharareh Eskandarieh Andre Faro Giuseppina Affinito Yaser Mohammed Al-Worafi Abhishek Anil Mohammad Amin Aalipour Dariush Abtahi Hiba Jawdat Barqawi Danish Ahmad Syed Shujait Ali Karem H. Alzoubi Yasser Bustanji Salahdein Aburuz Khursheed Aurangzeb Qorinah Estiningtyas Sakilah Adnani Deldar Morad Abdulah Qorinah Estiningtyas Sakilah Adnani Richard Gyan Aboagye Jalal Arabloo Mohammad Mahdi Bastan Sonu Bhaskar Mohammad Al-Wardat Ganiyu Adeniyi Amusa Demelash Areda Mahsa Asadi Anar Sait Ashina Joseph Uy Almazan Ashraf Alhumaidi Mohammad Ahmmad Mahmoud Al Zoubi Negar Sadat Ahmadi Andreas Kattem Husøy Yvonne Yiru Xu Jaimie D. Steinmetz Samir Abu Rumeileh Ali Ahmed Sawsan Alabbad Yazan Al-Ajlouni Obed Adonteng-Kissi Gelana Fekadu Hasan Aalruz Jasvinder Singh Bhatti C. J. Sanjay Natalia Cruz-Martins Edoardo Caronna Ana Paula Carvalho-E-Silva Jeetendra Bhandari Bijit Biswas Aleksandr Y. Aravkin Omid Dadras Hongyuan Chu Josielli Comachio Arian Azadnia Youngoh Bae Rehana Basri Jina Behjati Daniela Contreras Gurjit Kaur Bhatti Rajbir Bhatti Emanuele D'Amico Anh Kim Dang Lucio D'Anna Bruno Bizzozero-Peroni Meriem Boukhiam Sindhura Deekonda Pouria Delbari Andreas K. Demetriades Emina Dervišević Lamiaa Labieb Mahmoud Ebraheim Ebrahim Eini Michael Ekholuenetale Vinoth Gnana Chellaiyan Devanbu Mohammad Asghari-Jafarabadi Razieh Bahreini Bibha Dhungel Maryam Bemanalizadeh Mohammed Albashtawy Fadwa Naji Alhalaiqa Joseph Uy Almazan Sohrab Amiri Asma Ahmed Montaha Al-Iede David B. Anderson C. J. Sanjay Natalia Cruz-Martins Valery L. Feigin Awais Altaf Ahmed Y. Azzam Mohammed Usman Ali Najim Z. Alshahrani Soham Bandyopadhyay Xueting Ding Huyen Phuc Do Ojas Prakashbhai Doshi Siddhartha Dutta Sandip Chakraborty Luis Alberto Cámera Azadeh Bashiri Vijay Kumar Chattu Amol S. Dhane Archith Boloor Patrick R. Ching Xiaochen Dai Anis Ahmad Chaudhary Shahzaib Ahmed

Publication Name: Lancet Neurology

Publication Date: 2025-12-01

Volume: 24

Issue: 12

Page Range: 1005-1015

Description:

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.

Open Access: Yes

DOI: 10.1016/S1474-4422(25)00402-8

Authors - 104

Sharareh Eskandarieh

57211720158

Andre Faro

36770969600

Giuseppina Affinito

57220067141

Yaser Mohammed Al-Worafi

58143034700

Abhishek Anil

58164007300

Mohammad Amin Aalipour

57221831253

Dariush Abtahi

18036750600

Hiba Jawdat Barqawi

59730836600

Danish Ahmad

57202805842

Syed Shujait Ali

57188688612

Karem H. Alzoubi

8579544200

Yasser Bustanji

8847282600

Salahdein Aburuz

59755057900

Khursheed Aurangzeb

57194517674

Qorinah Estiningtyas Sakilah Adnani

57211604149

Deldar Morad Abdulah

57200190808

Qorinah Estiningtyas Sakilah Adnani

60038796000

Richard Gyan Aboagye

57221438826

Jalal Arabloo

57208760927

Mohammad Mahdi Bastan

58798063200

Sonu Bhaskar

57192268582

Mohammad Al-Wardat

60341546600

Ganiyu Adeniyi Amusa

36934039400

Demelash Areda

60264054900

Mahsa Asadi Anar

60347134800

Sait Ashina

6505788426

Joseph Uy Almazan

59928547800

Ashraf Alhumaidi

59172792400

Mohammad Ahmmad Mahmoud Al Zoubi

59997998700

Negar Sadat Ahmadi

57200289516

Andreas Kattem Husøy

57144347100

Yvonne Yiru Xu

57226430004

Jaimie D. Steinmetz

60231930400

Samir Abu Rumeileh

59292922100

Ali Ahmed

57201189007

Sawsan Alabbad

57218990141

Yazan Al-Ajlouni

57192869693

Obed Adonteng-Kissi

56841541000

Gelana Fekadu

57216210596

Hasan Aalruz

60262109200

Jasvinder Singh Bhatti

14043178800

C. J. Sanjay

60225493200

Natalia Cruz-Martins

60211464800

Edoardo Caronna

57204017223

Ana Paula Carvalho-E-Silva

56503814000

Jeetendra Bhandari

57190685987

Bijit Biswas

57200084942

Aleksandr Y. Aravkin

35386103000

Omid Dadras

57205721978

Hongyuan Chu

58083954200

Josielli Comachio

56532512200

Arian Azadnia

57208648349

Youngoh Bae

60175445800

Rehana Basri

55444650000

Jina Behjati

58925564100

Daniela Contreras

60351217000

Gurjit Kaur Bhatti

6602421376

Rajbir Bhatti

26022895800

Emanuele D'Amico

59202007400

Anh Kim Dang

57195728465

Lucio D'Anna

35309764000

Bruno Bizzozero-Peroni

57223233433

Meriem Boukhiam

59904024100

Sindhura Deekonda

59998293000

Pouria Delbari

58885030400

Andreas K. Demetriades

7004877691

Emina Dervišević

57209465870

Lamiaa Labieb Mahmoud Ebraheim

57201382941

Ebrahim Eini

56031829700

Michael Ekholuenetale

57189344745

Vinoth Gnana Chellaiyan Devanbu

60262699600

Mohammad Asghari-Jafarabadi

57226675591

Razieh Bahreini

58221294800

Bibha Dhungel

57209098892

Maryam Bemanalizadeh

57220071266

Mohammed Albashtawy

57203680806

Fadwa Naji Alhalaiqa

54895003400

Joseph Uy Almazan

57202002090

Sohrab Amiri

57195335343

Asma Ahmed

60285534700

Montaha Al-Iede

56823547000

David B. Anderson

57206183701

C. J. Sanjay

58122068200

Natalia Cruz-Martins

57203415019

Valery L. Feigin

57203677957

Awais Altaf

57201900507

Ahmed Y. Azzam

57208274797

Mohammed Usman Ali

57726370200

Najim Z. Alshahrani

57222248550

Soham Bandyopadhyay

57205736837

Xueting Ding

58616117500

Huyen Phuc Do

60211218200

Ojas Prakashbhai Doshi

59748102300

Siddhartha Dutta

57217989206

Sandip Chakraborty

59126608900

Luis Alberto Cámera

7003354253

Azadeh Bashiri

56900999700

Vijay Kumar Chattu

55743746500

Amol S. Dhane

58542222900

Archith Boloor

36192710300

Patrick R. Ching

57226415941

Xiaochen Dai

57221591169

Anis Ahmad Chaudhary

55419607600

Shahzaib Ahmed

58910858100