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

## TL;DR

This study analyzed the changing burden of headache disorders in Europe from 1990 to 2021, finding that while the number of cases increased, age-standardized rates remained stable.

## Contribution

The study provides a comprehensive, region-specific analysis of headache disorder trends in Europe using the Global Burden of Disease Study 2021.

## Key findings

- The number of individuals with headache disorders in Europe increased from 345.0 to 370.6 million between 1990 and 2021.
- Migraine burden increased slightly, while tension-type headache decreased in both prevalence and disability-adjusted life years.
- Higher socio-demographic index scores correlated with increased migraine burden but decreased tension-type headache burden.

## 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.