Global Epidemiology and Burden of Migraine in Children and Adolescents from 1990 to 2021: Insights from the Global Burden of Disease Study 2021.

Purpose: Migraine is the most disabling neurological disorder in children and adolescents. This study aimed to comprehensively assess the global burden of migraine in children and adolescents. Methods: Utilizing the latest data from the Global Burden of Disease (GBD) 2021, trends and disparities in incidence, prevalence, and disability-adjusted life years (DALYs) for migraine among children and adolescents were quantified by sex, age, socio-demographic index (SDI), region, and country. Decomposition analysis and frontier analyses were applied to investigate the underlying factors for changes in burden and the potential for future improvements, respectively. Results: In 2021, there were 36,794,858 new cases, 205,729,235 prevalent cases, and 7,515,775 DALYs caused by migraine in children and adolescents. From 1990 to 2021, age-standardised incidence rates (ASIR), age-standardised prevalence rates (ASPR), and age-standardised rates of DALYs (ASDR) for migraine in children and adolescents have risen, particularly among males, adolescents aged 15-19 years, regions with middle and higher SDI, East Asia, and Norway. Overall, the burden was higher in females than in males. In 2021, adolescents aged 10-14 exhibited the highest ASIR, whereas adolescents aged 15-19 had the highest ASPR and ASDR. The highest ASPR and ASDR were in low-middle SDI regions, while the highest ASIR was in high SDI regions. Tropical Latin America and Brazil had the highest ASRs regionally and nationally, respectively. Population growth and epidemiological changes drove the increase in DALYs. Regions with middle and higher SDIs hold the greatest improvement potential. Conclusion: The global burden of migraine in children and adolescents has increased substantially, disproportionately affecting females, adolescents aged 15-19 years, and low-middle SDI regions, while the greatest potential for improvement lies in middle and higher SDI regions, especially Brazil. These findings underscore the need for targeted public health policies and interventions tailored to pediatric migraine across diverse settings.