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, Feigin VL, Vos T, et al. Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study. JAMA Neurol. 2021;78(2):165-176doi: 10.1001/jamaneurol.2020.4152.
, Feigin, V. L., Vos, T., Alahdab, F., Amit, A. M. L., Bärnighausen, T. W., Beghi, E., Beheshti, M., Chavan, P. P., Criqui, M. H., Desai, R., Dhamminda Dharmaratne, S., Dorsey, E. R., Wilder Eagan, A., Elgendy, I. Y., Filip, I., Giampaoli, S., Giussani, G., Hafezi-Nejad, N., Hole, M. K., Ikeda, T., Owens Johnson, C., Kalani, R., Khatab, K., Khubchandani, J., Kim, D., Koroshetz, W. J., Krishnamoorthy, V., Krishnamurthi, R. V., Liu, X., Lo, W. D., Logroscino, G., Mensah, G. A., Miller, T. R., Mohammed, S., Mokdad, A. H., Moradi-Lakeh, M., Morrison, S. D., Shivamurthy, V. K. N., Naghavi, M., Nichols, E., Norrving, B., Odell, C. M., Pupillo, E., Radfar, A., Roth, G. A., Shafieesabet, A., Sheikh, A., Sheikhbahaei, S., Shin, J. I., Singh, J. A., Steiner, T. J., Stovner, L. J., Wallin, M. T., Weiss, J., Wu, C., Zunt, J. R., Adelson, J. D., & Murray, C. J. L. (2021). Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study. JAMA neurology, 78(2), 165-176. https://doi.org/10.1001/jamaneurol.2020.4152
, et al. "Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study." JAMA neurology vol. 78,2 (2021): 165-176. doi: https://doi.org/10.1001/jamaneurol.2020.4152
, Feigin VL, Vos T, Alahdab F, Amit AML, Bärnighausen TW, Beghi E, Beheshti M, Chavan PP, Criqui MH, Desai R, Dhamminda Dharmaratne S, Dorsey ER, Wilder Eagan A, Elgendy IY, Filip I, Giampaoli S, Giussani G, Hafezi-Nejad N, Hole MK, Ikeda T, Owens Johnson C, Kalani R, Khatab K, Khubchandani J, Kim D, Koroshetz WJ, Krishnamoorthy V, Krishnamurthi RV, Liu X, Lo WD, Logroscino G, Mensah GA, Miller TR, Mohammed S, Mokdad AH, Moradi-Lakeh M, Morrison SD, Shivamurthy VKN, Naghavi M, Nichols E, Norrving B, Odell CM, Pupillo E, Radfar A, Roth GA, Shafieesabet A, Sheikh A, Sheikhbahaei S, Shin JI, Singh JA, Steiner TJ, Stovner LJ, Wallin MT, Weiss J, Wu C, Zunt JR, Adelson JD, Murray CJL. Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study. JAMA Neurol. 2021 Feb 01;78(2):165-176. doi: 10.1001/jamaneurol.2020.4152. PMID: 33136137; PMCID: PMC7607495.
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JAMA Neurol. 2021 Feb 01;78(2):165-176. doi: 10.1001/jamaneurol.2020.4152.

Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study.

JAMA neurology

Valery L Feigin, Theo Vos, Fares Alahdab, Arianna Maever L Amit, Till Winfried Bärnighausen, Ettore Beghi, Mahya Beheshti, Prachi P Chavan, Michael H Criqui, Rupak Desai, Samath Dhamminda Dharmaratne, E Ray Dorsey, Arielle Wilder Eagan, Islam Y Elgendy, Irina Filip, Simona Giampaoli, Giorgia Giussani, Nima Hafezi-Nejad, Michael K Hole, Takayoshi Ikeda, Catherine Owens Johnson, Rizwan Kalani, Khaled Khatab, Jagdish Khubchandani, Daniel Kim, Walter J Koroshetz, Vijay Krishnamoorthy, Rita V Krishnamurthi, Xuefeng Liu, Warren David Lo, Giancarlo Logroscino, George A Mensah, Ted R Miller, Salahuddin Mohammed, Ali H Mokdad, Maziar Moradi-Lakeh, Shane Douglas Morrison, Veeresh Kumar N Shivamurthy, Mohsen Naghavi, Emma Nichols, Bo Norrving, Christopher M Odell, Elisabetta Pupillo, Amir Radfar, Gregory A Roth, Azadeh Shafieesabet, Aziz Sheikh, Sara Sheikhbahaei, Jae Il Shin, Jasvinder A Singh, Timothy J Steiner, Lars Jacob Stovner, Mitchell Taylor Wallin, Jordan Weiss, Chenkai Wu, Joseph Raymond Zunt, Jaimie D Adelson, Christopher J L Murray

Affiliations

  1. Faculty of Health and Environmental Sciences, Auckland University of Technology School of Public Health and Psychosocial Studies, Auckland, New Zealand.
  2. Institute for Health Metrics and Evaluation, University of Washington, Seattle.
  3. Research Center of Neurology, Moscow, Russia.
  4. Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle.
  5. Mayo Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota.
  6. Department of Epidemiology and Biostatistics, University of the Philippines Manila, Manila, Philippines.
  7. Johns Hopkins University School of Public Health, Baltimore, Maryland.
  8. Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
  9. Harvard University T.H. Chan School of Public Health, Boston, Massachusetts.
  10. Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy.
  11. Department of Physical Medicine and Rehabilitation, New York University, New York.
  12. Department of Epidemiology and Environmental Health, the University of Buffalo, Buffalo, New York.
  13. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla.
  14. Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia.
  15. Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
  16. University of Rochester, Rochester, New York.
  17. Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts.
  18. Department of Social Services, Tufts Medical Center, Boston, Massachusetts.
  19. Division of Cardiology, Massachusetts General Hospital, Boston.
  20. Division of Cardiology, Harvard University, Boston, Massachusetts.
  21. Psychiatry Department, Kaiser Permanente, Fontana, California.
  22. A.T. Still University School of Osteopathic Medicine in Arizona, Arizona School of Health Sciences, Mesa, Arizona.
  23. Department of Cardiovascular Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy.
  24. Laboratory of Neurological Disorders, Mario Negri Institute for Pharmacological Research, Milan, Italy.
  25. Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland.
  26. Tehran University of Medical Sciences School of Medicine, Tehran, Iran.
  27. Department of Pediatrics, The University of Texas, Austin, Austin.
  28. Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand.
  29. Department of Neurology, University of Washington, Seattle.
  30. Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom.
  31. Ohio University College of Arts and Sciences, Zanesville.
  32. Department of Nutrition and Health Science, Ball State University, Muncie, Indiana.
  33. Department of Health Sciences, Northeastern University, Boston, Massachusetts.
  34. National Institutes of Neurological Disorders and Stroke, National Institute of Health, Bethesda, Maryland.
  35. Department of Anesthesiology, Duke University, Durham, North Carolina.
  36. Department of Anesthesiology, University of Washington, Seattle.
  37. Department of Systems, Populations, and Leadership, University of Michigan, Ann Arbor.
  38. Department of Pediatrics, Ohio State University, Columbus.
  39. Department of Pediatric Neurology, Nationwide Children's Hospital, Columbus, Ohio.
  40. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
  41. Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy.
  42. Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, Maryland.
  43. Department of Medicine, University of Cape Town, Cape Town, South Africa.
  44. Pacific Institute for Research & Evaluation, Calverton, Maryland.
  45. School of Public Health, Curtin University, Perth, Australia.
  46. Department of Biomolecular Sciences, University of Mississippi, Oxford.
  47. Department of Pharmacy, Mizan-Tepi University, Mizan, Ethiopia.
  48. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
  49. Section of Plastic Surgery, University of Michigan, Ann Arbor.
  50. Department of Neurology, Emory University, Atlanta, Georgia.
  51. Department of Clinical Sciences, Lund University, Lund, Sweden.
  52. University of Central Florida College of Medicine, Orlando.
  53. Division of Cardiology, University of Washington, Seattle.
  54. Department of Cardiology, Charité Medical University Berlin, Berlin, Germany.
  55. Center for Stroke Research Berlin, Berlin, Germany.
  56. Centre for Medical Informatics, University of Edinburgh, Edinburgh, United Kingdom.
  57. Division of General Internal Medicine, Harvard University, Boston, Massachusetts.
  58. Yonsei University College of Medicine, Seoul, South Korea.
  59. The University of Alabama at Birmingham School of Medicine, Birmingham.
  60. Medicine Service, US Department of Veterans Affairs, Birmingham, Alabama.
  61. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
  62. Division of Brain Sciences, Imperial College London, London, United Kingdom.
  63. Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, Trondheim, Norway.
  64. Department of Neurology, George Washington University, Washington, DC.
  65. University of Maryland School of Medicine, Baltimore.
  66. Department of Demography, University of California, Berkeley, Berkeley.
  67. Global Health Research Center, Duke Kunshan University, Kunshan, China.
  68. Duke Global Health Institute, Duke University, Durham, North Carolina.

PMID: 33136137 PMCID: PMC7607495 DOI: 10.1001/jamaneurol.2020.4152

Abstract

IMPORTANCE: Accurate and up-to-date estimates on incidence, prevalence, mortality, and disability-adjusted life-years (burden) of neurological disorders are the backbone of evidence-based health care planning and resource allocation for these disorders. It appears that no such estimates have been reported at the state level for the US.

OBJECTIVE: To present burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017.

DESIGN, SETTING, AND PARTICIPANTS: This is a systematic analysis of the Global Burden of Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were analyzed: stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis, and tetanus.

EXPOSURES: Any of the 14 listed neurological diseases.

MAIN OUTCOME AND MEASURE: Absolute numbers in detail by age and sex and age-standardized rates (with 95% uncertainty intervals) were calculated.

RESULTS: The 3 most burdensome neurological disorders in the US in terms of absolute number of DALYs were stroke (3.58 [95% uncertainty interval [UI], 3.25-3.92] million DALYs), Alzheimer disease and other dementias (2.55 [95% UI, 2.43-2.68] million DALYs), and migraine (2.40 [95% UI, 1.53-3.44] million DALYs). The burden of almost all neurological disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as DALYs) increased from 1990 to 2017, largely because of the aging of the population. Exceptions for this trend included traumatic brain injury incidence (-29.1% [95% UI, -32.4% to -25.8%]); spinal cord injury prevalence (-38.5% [95% UI, -43.1% to -34.0%]); meningitis prevalence (-44.8% [95% UI, -47.3% to -42.3%]), deaths (-64.4% [95% UI, -67.7% to -50.3%]), and DALYs (-66.9% [95% UI, -70.1% to -55.9%]); and encephalitis DALYs (-25.8% [95% UI, -30.7% to -5.8%]). The different metrics of age-standardized rates varied between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while northern states had a relatively higher burden of multiple sclerosis and eastern states had higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache, and meningitis, encephalitis, and tetanus.

CONCLUSIONS AND RELEVANCE: There is a large and increasing burden of noncommunicable neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in particular neurological disorders across the US states. The information reported in this article can be used by health care professionals and policy makers at the national and state levels to advance their health care planning and resource allocation to prevent and reduce the burden of neurological disorders.

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