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 in: Lancet neurology 2024-04, Vol.23 (4), p.344-381
• Main Authors: Abdollahi, Mozhan, Aboagye, Richard Gyan, Abu-Gharbieh, Eman, Ali, Syed Shujait Shujait, Aljunid, Syed Mohamed, Alqahtani, Jaber S, Alvis-Guzman, Nelson, Aravkin, Aleksandr Y, Artanti, Kurnia Dwi, Ashraf, Muhammad, Baghdadi, Soroush, Barchitta, Martina, Baune, Bernhard T, Bettencourt, Paulo J G, Bikbov, Boris, Carreras, Giulia, Caye, Arthur, Chu, Dinh-Toi, Chukwu, Isaac Sunday, Columbus, Alyssa, Comachio, Josielli, Dandona, Lalit, Darwish, Amira Hamed, Dirac, M Ashworth, Do, Thao Huynh Phuong, Dsouza, Haneil Larson, Faramarzi, Ali, Fornari, Arianna, Garg, Naval, Ghaderi Yazdi, Bardiya, Goleij, Pouya, Gomes-Neto, Mansueto, Hadei, Mostafa, Jahrami, Haitham, Johnson, Catherine Owens, Kabito, Gebisa Guyasa, Kaliyadan, Feroze, Karanth, Shama D, Kaur, Harkiran, Kaur, Navjot, Khan, Maseer, Kim, Yun Jin, Kisa, Adnan, Kravchenko, Michael A, Krishnamoorthy, Vijay, Kundu, Satyajit, Le, Long Khanh Dao, Li, Wei, Liu, Jue, Logroscino, Giancarlo, Mabrok, Mahmoud, Maghbouli, Nastaran, Mathangasinghe, Yasith, Maugeri, Andrea, Mendoza, Walter, Miazgowski, Tomasz, Minh, Le Huu Nhat, Misganaw, Awoke, Misra, Sanjeev, Moraga, Paula, Morovatdar, Negar, Musaigwa, Fungai, Naik, Ganesh R, Najmuldeen, Hastyar Hama Rashid, Naser, Abdallah Y, Nazri-Panjaki, Athare, Negash, Hadush, Negoi, Ruxandra Irina, Oancea, Bogdan, Okekunle, Akinkunmi Paul, Pacheco-Barrios, Kevin, Pandey, Anamika, Pereira, David M, Pereira, Maria Odete, Poddighe, Dimitri, Prakash, Peralam Yegneswaran, Rahman, Muhammad Aziz, Rahmani, Shayan, Ramazanu, Sheena, Rasouli-Saravani, Ashkan, Robinson, Stephen R, Rodriguez, Jefferson Antonio Buendia, Ronfani, Luca, Sahraian, Mohammad Ali, Shama, Adisu Tafari T, Shamim, Muhammad Aaqib, Siankam Tankwanchi, Akhenaten Benjamin, Spartalis, Michael, Sun, Jing, Ticoalu, Jansje Henny Vera, Tovani-Palone, Marcos Roberto, Traini, Eugenio, Valizadeh, Rohollah, Vervoort, Dominique, Vinueza Veloz, Andres Fernando, Wang, Yanzhong, Winkler, Andrea Sylvia, Xu, Suowen, Yaghoubi, Sajad, Zegeye, Zelalem Banjaw
• Format: Article
• Language: English
• Subjects: Autism Spectrum Disorder; Communicable Diseases; Communicable Diseases - epidemiology; COVID-19; COVID-19 - epidemiology; Diabetic Neuropathies; Disease Progression; epidemiology; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Global Burden of Disease; Global Health; Humans; Infant; Infant, Newborn; Life Expectancy; Life Sciences; Medicin och hälsovetenskap; Neurologi; Neurology; Newborn; Premature Birth; Public Health, Global Health, Social Medicine and Epidemiology; Quality-Adjusted Life Years; Risk Factors; Zika Virus; Zika Virus Infection
• ISSN: 1474-4422; 1474-4465; 1474-4465
• DOI: 10.1016/S1474-4422(24)00038-3

Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised