ORIGINAL RESEARCH article
Front. Neurol.
Sec. Headache and Neurogenic Pain
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1629025
Global Burden Trends of Tension-Type Headache, 1990-2021: Sociodemographic Patterns, Age-Period-Cohort Effects, and Frontier Analysis from the GBD 2021 Study
Provisionally accepted
- 1Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 2Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 3Affiliated Hospital of Panzhihua University, Panzhihua, China
- 4School of Electronic Information and Electrical Engineering, Chengdu University, Chengdu, China
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Background Tension-type headache (TTH) is one of the most prevalent neurological disorders globally. While previous studies have examined TTH epidemiology across different regions, few have comprehensively analyzed how sociodemographic factors influence its patterns and trends. This study aimed to analyze TTH burden trends from 1990 to 2021 and their relationship with sociodemographic development. Methods Data on prevalence, incidence, and years lived with disability (YLDs) for TTH were extracted from the Global Burden of Disease Study (GBD) 2021, covering global, 5 SDI regions, 21 regions, and 204 countries. We used absolute numbers and age-standardized rates from 1990 to 2021. Spearman correlation assessed the relationship between rates and the Sociodemographic Index (SDI). An age-periodcohort model disentangled temporal effects across different SDI levels, while frontier analysis evaluated improvement potential relative to SDI.Results Despite modest decreases in age-standardized rates (prevalence: -0.56%, incidence: -0.32%, YLDs: -2.27%), absolute TTH cases reached 2.01 billion in 2021, increasing 56.4% from 1990. TTH burden showed moderate positive correlations with SDI, with High SDI regions having highest rates. Contrasting trends emerged: globally and in High and High-middle SDI regions rates decreased, while Middle SDI regions showed significant increases (prevalence: +5.83%). APC analysis revealed global peak prevalence at age 32.5 years, with period effects showing decreases in High SDI regions but increases in Middle SDI regions. Cohort effects indicated decreasing risks in recent High/High-middle SDI cohorts but increasing risks in Middle SDI regions.Our research reveals that TTH remains a substantial global health challenge, with its burden increasingly shifting towards younger populations in middleincome countries. This epidemiological transition, coupled with significant untapped potential for burden reduction even in high-SDI nations, demands the urgent development of context-specific public health strategies to mitigate the growing impact of this highly prevalent disorder.
Keywords: Tension-Type Headache, Global Burden of Disease study, sociodemographic index, Age-Period-Cohort analysis, Frontier analysis
Received: 22 May 2025; Accepted: 28 Jun 2025.
Copyright: © 2025 Wang, Liao, Liu, Chen, Xie and Tian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuanlun Xie, School of Electronic Information and Electrical Engineering, Chengdu University, Chengdu, China
Li Tian, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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