According to the recent study “Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021”, published on March 14, 2024 in Lancet Neurology, migraine is the most burdensome neurological disease in Western Europe. Following migraine in first place are stroke (second place), dementia (third place), diabetic neuropathy (fourth place), autism spectrum disorders (fifth place), cancers of the nervous system (sixth place), epilepsy (seventh place), consequences of premature birth (eighth place), neonatal brain injuries (ninth place), and spinal cord injuries (tenth place).

The study analyzed the health loss of the nervous system caused by 37 diseases and their associated risk factors worldwide, regionally, and nationally from 1990 to 2021. Mortality, the prevalence of years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) were recorded by age and sex in 204 countries and territories for the same period. Morbidity and deaths due to neurological diseases where the health loss was directly attributable to damage to the central or peripheral nervous system were included.

Risk of neurological diseases depending on gender

A core method in studies on the "Global Burden of Disease" is the DALY concept. DALY stands for "disability-adjusted life years," which roughly translates to "lost healthy years of life." This concept compares the years a person is disabled or limited by a disease, as well as disease-related deaths, to a hypothetical healthy lifespan up to their life expectancy. As the current study describes, the number of DALYs for 37 neurological diseases considered increased from 375 million in 1990 to 443 million in 2021. Diseases of the nervous system contribute to more DALYs in men, but a higher prevalence in women (mainly migraine and tension-type headaches).

“In Western Europe, migraine tops the list of the most debilitating neurological diseases. This is especially true for women and often affects decades of their lives. Headache disorders are among the most common diseases of the nervous system. Headache disorders, characterized by recurring headaches, can be associated with severe personal and societal burdens such as pain, disability, reduced quality of life, and financial costs. However, worldwide, only a minority of people with headache disorders receive an appropriate medical diagnosis. Headaches are underestimated, underdiagnosed, and undertreated globally,” commented Prof. Dr. Hartmut Göbel, Director of the Kiel Pain Clinic, on the findings.

“Neurological diseases cause immense suffering for affected individuals and families, and deprive communities and economies of their human capital,” WHO Director-General Tedros Adhanom Ghebreyesus explained in a statement. “This study should be an urgent call to action to strengthen targeted interventions so that the growing number of people with neurological diseases have access to the high-quality care, treatment, and rehabilitation they need.”