Rising Trends in the Burden of Migraine among Children and Adolescents: A Comprehensive Analysis from 1990 to 2021 with Future Predictions

Qian Wang^1,2,3Rong Luo^2,3Qianhui Wen^2,3*

• ¹Sichuan University, Chengdu, China
• ²Sichuan University West China Second University Hospital, Chengdu, China
• ³Sichuan University West China Second University Hospital Sichuan Provincial Key Laboratory of Development and Women and Children's Diseases, Chengdu, China

Background: Migraine is a leading neurological disorder among children and adolescents. Its high prevalence and risk of chronic progression significantly reduce quality of life and are linked to mental health issues and learning difficulties. Despite available diagnostic standards and treatments, global challenges remain, including underdiagnosis and unequal healthcare access, especially in developing countries where health systems are unprepared for rising cases. Analyzing long-term patterns and contributing factors of pediatric migraine is crucial for improving healthcare planning and prevention strategies. Methods: Using data from the Global Burden of Disease Study (GBD), this study analyzed migraine epidemiology in 5-19-year-olds across 204 countries and territories during 1990-2021. Disease burden trends were quantified through age-standardized rates (ASR) and estimated annual percentage changes (EAPC). Regions were categorized into five distinct tiers according to the Sociodemographic Index (SDI). Furthermore, a Bayesian age-period-cohort model was implemented to project disease burden trends through 2035. Results: From 1990 to 2021, global migraine cases among children and adolescents increased from 165,687,027.67 to 205,729,235.09, marking a 24.17% rise, with disability-adjusted life years (DALYs) growing by 24.38%. Low-middle SDI regions bore the heaviest disease burden, reporting 65,004,285.01 cases in 2021—triple that of high SDI regions. Females exhibited significantly higher prevalence, incidence, and DALYs than males. Trend analysis revealed declining disease burden in low-middle SDI regions but rising rates in high SDI regions. Despite projected declines in global age-standardized migraine prevalence, incidence, and DALYs by 2035, adolescents aged 15-19 are still anticipated to face disproportionately high disease burdens. Conclusions: The burden of migraine among children and adolescents exhibits significant geographical and gender heterogeneity, necessitating targeted optimization of healthcare resource allocation. Strengthening primary care diagnostic capacity, promoting standardized treatment guidelines, and prioritizing disease prevention and control in low-income regions are critical to alleviating the global burden.