Lancet Neurol. 2025 Dec;24(12):1005-1015. doi: 10.1016/S1474-4422(25)00402-8.
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.
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.
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.
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.
Gates Foundation.
《2023年全球疾病、伤害及风险因素负担研究》（GBD 2023）对偏头痛、紧张型头痛和药物过量使用性头痛造成的健康损失进行了评估。本研究展示了1990年至2023年因头痛所致负担的最新结果，以及其临床和公共卫生意义。
从已发表的基于人群的研究中提取偏头痛、紧张型头痛和药物过量使用性头痛的患病率、发病率或缓解率数据。我们使用分层贝叶斯元回归模型来估计头痛疾病在全球、区域和国家层面的患病率。《2023年全球疾病负担研究》首次通过对来自世界各地18个国家普通人群的41653名个体的个体参与者数据进行荟萃分析，得出了特定年龄和性别的症状期时间估计值。应用残疾权重来计算残疾调整生命年（YLDs）。由于药物过量使用性头痛是原发性头痛治疗不当的后遗症（由于药物过度使用），根据三项纵向研究的荟萃分析结果，其负担被重新归因于偏头痛或紧张型头痛。
2023年，29亿人（95%不确定区间为26亿至31亿）受头痛疾病影响，全球年龄标准化患病率为34.6%（31.6% - 37.5%），每10万人的YLD率为541.9（373.4 - 739.9），其中每10万人中487.5（323.0 - 678.8）归因于偏头痛。在过去三十年中，这些头痛疾病的患病率一直保持稳定。因头痛疾病导致的YLD率在女性中（每10万人739.9 [511.2 - 1011.5]）是男性中（每10万人346.1 [240.4 - 481.8]）的两倍多。药物过量使用性头痛在男性紧张型头痛的YLD估计中占58.9%，在女性中占56.1%，在男性偏头痛的YLD估计中占22.6%，在女性中占14.1%。
头痛疾病，尤其是偏头痛，仍然是一项重大的全球健康挑战，这凸显了有效管理和预防策略的必要性。通过避免药物（包括非处方药）的过度使用，可以避免或消除许多因头痛所致的负担，这突出了公众教育的重要性。
盖茨基金会。
