Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 study

BackgroundTension-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 socio-demographic factors influence its patterns and trends. This study aimed to a...

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Main Authors: Can Wang, Chao Liao, Yuyin Liu, Peng Chen, Yuanlun Xie, Li Tian
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1629025/full
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author Can Wang
Can Wang
Chao Liao
Yuyin Liu
Yuyin Liu
Peng Chen
Yuanlun Xie
Li Tian
author_facet Can Wang
Can Wang
Chao Liao
Yuyin Liu
Yuyin Liu
Peng Chen
Yuanlun Xie
Li Tian
author_sort Can Wang
collection DOAJ
description BackgroundTension-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 socio-demographic factors influence its patterns and trends. This study aimed to analyze TTH burden trends from 1990 to 2021 and their relationship with socio-demographic development.MethodsData 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 Socio-Demographic Index (SDI). An age-period-cohort model disentangled temporal effects across different SDI levels, while frontier analysis evaluated improvement potential relative to SDI.ResultsDespite 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.ConclusionOur research reveals that TTH remains a substantial global health challenge, with its burden increasingly shifting toward younger populations in middle-income 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.
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spelling doaj-art-d70abcf10ece4e45817964e9932335b82025-08-20T03:27:47ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16290251629025Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 studyCan Wang0Can Wang1Chao Liao2Yuyin Liu3Yuyin Liu4Peng Chen5Yuanlun Xie6Li Tian7Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaChengdu University of Traditional Chinese Medicine, Chengdu, ChinaHospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaHospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaChengdu University of Traditional Chinese Medicine, Chengdu, ChinaAffiliated Hospital of Panzhihua University, Panzhihua, ChinaSchool of Electronic Information and Electrical Engineering, Chengdu University, Chengdu, ChinaHospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaBackgroundTension-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 socio-demographic factors influence its patterns and trends. This study aimed to analyze TTH burden trends from 1990 to 2021 and their relationship with socio-demographic development.MethodsData 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 Socio-Demographic Index (SDI). An age-period-cohort model disentangled temporal effects across different SDI levels, while frontier analysis evaluated improvement potential relative to SDI.ResultsDespite 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.ConclusionOur research reveals that TTH remains a substantial global health challenge, with its burden increasingly shifting toward younger populations in middle-income 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.https://www.frontiersin.org/articles/10.3389/fneur.2025.1629025/fulltension-type headacheGlobal Burden of Disease studySocio-Demographic Indexage-period-cohort analysisfrontier analysis
spellingShingle Can Wang
Can Wang
Chao Liao
Yuyin Liu
Yuyin Liu
Peng Chen
Yuanlun Xie
Li Tian
Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 study
Frontiers in Neurology
tension-type headache
Global Burden of Disease study
Socio-Demographic Index
age-period-cohort analysis
frontier analysis
title Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 study
title_full Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 study
title_fullStr Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 study
title_full_unstemmed Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 study
title_short Global burden trends of tension-type headache, 1990–2021: socio-demographic patterns, age-period-cohort effects, and frontier analysis from the GBD 2021 study
title_sort global burden trends of tension type headache 1990 2021 socio demographic patterns age period cohort effects and frontier analysis from the gbd 2021 study
topic tension-type headache
Global Burden of Disease study
Socio-Demographic Index
age-period-cohort analysis
frontier analysis
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1629025/full
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