Trends in the Burden of Headache Disorders in Europe, 1990-2021: A Systematic Analysis from the Global Burden of Disease Study 2021

Abstract

Background/Objectives: Headache disorders, including migraine and tension-type headache (TTH), are among the most prevalent and disabling neurological conditions globally. This study aimed to evaluate temporal changes, demographic disparities, and socio-geographic variation in the burden of headache disorders across European countries. Methods: We analyzed data from the Global Burden of Disease Study 2021, covering 45 European countries grouped into Western, Central, and Eastern regions. We examined age-standardized prevalence, incidence, and disability-adjusted life year (DALY) rates for headache disorders between 1990 and 2021. Analyses were stratified by sex, age group, region, and country-level socio-demographic index (SDI). All estimates were reported with 95 percent uncertainty intervals where relevant. Spearman correlation was used to assess associations between disease burden and SDI. Results: Between 1990 and 2021, the number of individuals with headache disorders in Europe rose from 345.0 to 370.6 million, although age-standardized prevalence remained stable. The burden of migraine slightly increased, with age-standardized DALY rates rising from 648.35 to 657.27 per 100,000 population. Conversely, TTH showed a minor decline in both prevalence and DALY rates. Women and individuals aged 30 to 44 years consistently exhibited the highest burden, particularly for migraine. Higher SDI scores were positively correlated with DALY rates for migraine (rho = 0.392, p = 0.008) but negatively correlated for TTH (rho = -0.466, p = 0.001). Conclusions: Headache disorders continue to pose a major and largely unmitigated health burden across Europe. Regionally targeted strategies are essential to reduce disability and improve outcomes across diverse European populations.