Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Authors: Jaimie D Steinmetz, Katrin Maria Seeher, Nicoline Schiess, Emma Nichols, Bochen Cao, Chiara Servili, Vanessa Cavallera, Ewerton Cousin, Hailey Hagins, Madeline E Moberg, Max L Mehlman, Yohannes Habtegiorgis Abate, Jaffar Abbas, Madineh Akram Abbasi, Mohammadreza Abbasian, Hedayat Abbastabar, Michael Abdelmasseh, Mohammad Abdollahi, Mozhan Abdollahi, Mohammad-Amin Abdollahifar, Rami Abd-Rabu, Deldar Morad Abdulah, Auwal Abdullahi, Aidin Abedi, Vida Abedi, Roberto Ariel Abeldańo Zuńiga, Hassan Abidi, Olumide Abiodun, Richard Gyan Aboagye, Hassan Abolhassani, Victor Aboyans, Woldu Aberhe Abrha, Ahmed Abualhasan, Eman Abu-Gharbieh, Salahdein Aburuz, Lawan Hassan Adamu, Isaac Yeboah Addo, Oladimeji M Adebayo, Victor Adekanmbi, Tayo Alex Adekiya, Wirawan Adikusuma, Qorinah Estiningtyas Sakilah Adnani, Saryia Adra, Tsion Afework, Aanuoluwapo Adeyimika Afolabi, Ali Afraz, Saira Afzal, Shahin Aghamiri, Antonella Agodi, Williams Agyemang-Duah, Bright Opoku Ahinkorah, Aqeel Ahmad, Danish Ahmad, Sajjad Ahmad, Amir Mahmoud Ahmadzade, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Jivan Qasim Ahmed, Luai A Ahmed, Muktar Beshir Ahmed, Syed Anees Ahmed, Marjan Ajami, Budi Aji, Olufemi Ajumobi, Seyed Esma'il Akade, Morteza Akbari, Hossein Akbarialiabad, Shiva Akhlaghi, Karolina Akinosoglou, Rufus Olusola Akinyemi, Maxwell Akonde, Syed Mahfuz Al Hasan, Fares Alahdab, Tareq Mohammed Ali AL-Ahdal, Rasmieh Mustafa Al-amer, Mohammed Albashtawy, Mohammad T AlBataineh, Khalifah A Aldawsari, Hediyeh Alemi, Sharifullah Alemi, Abdelazeem M Algammal, Adel Ali Saeed Al-Gheethi, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Abid Ali, Endale Alemayehu Ali, Liaqat Ali, Mohammed Usman Ali, Musa Mohammed Ali, Rafat Ali, Shahid Ali, Syed Shujait Shujait Ali, Zahid Ali, Sheikh Mohammad Alif, Yousef Alimohamadi, Ahmednur Adem Aliyi, Mohamad Aljofan, Syed Mohamed Aljunid, Suvarna Alladi, Joseph Uy Almazan, Sami Almustanyir, Basem Al-Omari, Jaber S Alqahtani, Ibrahim Alqasmi, Ahmed Yaseen Alqutaibi, Rustam Al-Shahi Salman, Zaid Altaany, Jaffar A Al-Tawfiq, Khalid A Altirkawi, Nelson Alvis-Guzman, Yaser Mohammed Al-Worafi, Hany Aly, Safwat Aly, Karem H Alzoubi, Reza Amani, Alireza Amindarolzarbi, Sohrab Amiri, Mohammad Hosein Amirzade-Iranaq, Hubert Amu, Dickson A Amugsi, Ganiyu Adeniyi Amusa, Jimoh Amzat, Robert Ancuceanu, Deanna Anderlini, David B Anderson, Catalina Liliana Andrei, Sofia Androudi, Dhanalakshmi Angappan, Teklit W Angesom, Abhishek Anil, Alireza Ansari-Moghaddam, Razique Anwer, Mosab Arafat, Aleksandr Y Aravkin, Demelash Areda, Hany Ariffin, Hidayat Arifin, Mesay Arkew, Johan Ärnlöv, Mahwish Arooj, Anton A Artamonov, Kurnia Dwi Artanti, Raphael Taiwo Aruleba, Ali A Asadi-Pooya, Tilahun Ferede Asena, Mohammad Asghari-Jafarabadi, Muhammad Ashraf, Tahira Ashraf, Kendalem Asmare Atalell, Seyyed Shamsadin Athari, Bantalem Tilaye Tilaye Atinafu, Prince Atorkey, Maha Moh'd Wahbi Atout, Alok Atreya, Avinash Aujayeb, Abolfazl Avan, Beatriz Paulina Ayala Quintanilla, Haleh Ayatollahi, Olatunde O Ayinde, Seyed Mohammad Ayyoubzadeh, Sina Azadnajafabad, Zahra Azizi, Khalil Azizian, Ahmed Y Azzam, Mahsa Babaei, Muhammad Badar, Ashish D Badiye, Soroush Baghdadi, Sara Bagherieh, Ruhai Bai, Atif Amin Baig, Senthilkumar Balakrishnan, Shivanthi Balalla, Ovidiu Constantin Baltatu, Maciej Banach, Soham Bandyopadhyay, Indrajit Banerjee, Mehmet Firat Baran, Miguel A Barboza, Martina Barchitta, Mainak Bardhan, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Amadou Barrow, Davood Bashash, Hamideh Bashiri, Hameed Akande Bashiru, Afisu Basiru, João Diogo Basso, Sanjay Basu, Abdul-Monim Mohammad Batiha, Kavita Batra, Bernhard T Baune, Neeraj Bedi, Ahmet Begde, Tahmina Begum, Babak Behnam, Amir Hossein Behnoush, Maryam Beiranvand, Yannick Béjot, Alehegn Bekele, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Maryam Bemanalizadeh, Rose G Bender, Bright Benfor, Derrick A Bennett, Isabela M Bensenor, Betyna Berice, Paulo J G Bettencourt, Kebede A Beyene, Abhishek Bhadra, Devidas S Bhagat, Kayleigh Bhangdia, Nikha Bhardwaj, Pankaj Bhardwaj, Ashish Bhargava, Sonu Bhaskar, Ajay Nagesh Bhat, Vivek Bhat, Gurjit Kaur Bhatti, Jasvinder Singh Bhatti, Rajbir Bhatti, Ali Bijani, Boris Bikbov, Mariah Malak Bilalaga, Atanu Biswas, Saeid Bitaraf, Veera R Bitra, Tone Bjørge, Virginia Bodolica, Aadam Olalekan Bodunrin, Archith Boloor, Dejana Braithwaite, Carol Brayne, Hermann Brenner, Andrey Briko, Maria L Bringas Vega, Julie Brown, Christine M Budke, Danilo Buonsenso, Katrin Burkart, Richard A Burns, Yasser Bustanji, Muhammad Hammad Butt, Nadeem Shafique Butt, Zahid A Butt, Lucas Scotta Cabral, Florentino Luciano Caetano dos Santos, Daniela Calina, Ismael R Campos-Nonato, Chao Cao, Hélène Carabin, Rosario Cárdenas, Giulia Carreras, Andre F Carvalho, Carlos A Castańeda-Orjuela, Adriano Casulli, Ferrán Catalá-López, Alberico L Catapano, Arthur Caye, Luca Cegolon, Muthia Cenderadewi, Ester Cerin, Pamela R Chacón-Uscamaita, Jeffrey Shi Kai Chan, Gashaw Sisay Chanie, Jaykaran Charan, Vijay Kumar Chattu, Endeshaw Chekol Abebe, Hui Chen, Jianqi Chen, Gerald Chi, Fatemeh Chichagi, Saravana Babu Chidambaram, Ritesh Chimoriya, Patrick R Ching, Abdulaal Chitheer, Yuen Yu Chong, Hitesh Chopra, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Rajiv Chowdhury, Hanne Christensen, Dinh-Toi Chu, Isaac Sunday Chukwu, Eric Chung, Kaleb Coberly, Alyssa Columbus, Josielli Comachio, Joao Conde, Paolo Angelo Cortesi, Vera Marisa Costa, Rosa A S Couto, Michael H Criqui, Natália Cruz-Martins, Mohammad Amin Dabbagh Ohadi, Sriharsha Dadana, Omid Dadras, Xiaochen Dai, Zhaoli Dai, Emanuele D'Amico, Hadi A Danawi, Lalit Dandona, Rakhi Dandona, Amira Hamed Darwish, Saswati Das, Subasish Das, Ana Maria Dascalu, Nihar Ranjan Dash, Mohsen Dashti, Fernando Pio De la Hoz, Alejandro de la Torre-Luque, Diego De Leo, Frances E Dean, Amin Dehghan, Azizallah Dehghan, Hiwot Dejene, Daniel Demant, Andreas K Demetriades, Solomon Demissie, Xinlei Deng, Hardik Dineshbhai Desai, Vinoth Gnana Chellaiyan Devanbu, Kuldeep Dhama, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Diana Dias da Silva, Daniel Diaz, Mahmoud Dibas, Delaney D Ding, Monica Dinu, M Ashworth Dirac, Mengistie Diress, Thanh Chi Do, Thao Huynh Phuong Do, Khanh Duy Khanh Doan, Milad Dodangeh, Mohamed Fahmy Doheim, Klara Georgieva Dokova, Deepa Dongarwar, Haneil Larson Dsouza, John Dube, Senbagam Duraisamy, Oyewole Christopher Durojaiye, Sulagna Dutta, Arkadiusz Marian Dziedzic, Hisham Atan Edinur, Negin Eissazade, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Nevine El Nahas, Iman El Sayed, Mohammad Amin Elahi Najafi, Iffat Elbarazi, Noha Mousaad Elemam, Frank J Elgar, Islam Y Elgendy, Hala Rashad Elhabashy, Muhammed Elhadi, Legesse Tesfaye Elilo, Richard G Ellenbogen, Omar Abdelsadek Abdou Elmeligy, Mohamed A Elmonem, Mohammed Elshaer, Ibrahim Elsohaby, Mehdi Emamverdi, Theophilus I Emeto, Matthias Endres, Christopher Imokhuede Esezobor, Sharareh Eskandarieh, Abdolmajid Fadaei, Adeniyi Francis Fagbamigbe, Ayesha Fahim, Ali Faramarzi, Jawad Fares, Mohsen Farjoud Kouhanjani, Andre Faro, Farshad Farzadfar, Ali Fatehizadeh, Mobina Fathi, Saeid Fathi, Syeda Anum Fatima Fatima, Alireza Feizkhah, Seyed-Mohammad Fereshtehnejad, Alize J Ferrari, Nuno Ferreira, Getahun Fetensa, Neda Firouraghi, Florian Fischer, Ana Catarina Fonseca, Lisa M Force, Arianna Fornari, Behzad Foroutan, Takeshi Fukumoto, Muktar A Gadanya, Abhay Motiramji Gaidhane, Yaseen Galali, Nasrin Galehdar, Quan Gan, Aravind P Gandhi, Balasankar Ganesan, William M Gardner, Naval Garg, Shuo-Yan Gau, Rupesh K Gautam, Teshome Gebre, Mesfin Gebrehiwot, Gebreamlak Gebremedhn Gebremeskel, Haftay Gebremedhin Gebreslassie, Lemma Getacher, Bardiya Ghaderi Yazdi, Fataneh Ghadirian, Fariborz Ghaffarpasand, Reza Ghanbari, MohammadReza Ghasemi, Ramy Mohamed Ghazy, Sailaja Ghimire, Ali Gholami, Ali Gholamrezanezhad, Elena Ghotbi, Sherief Ghozy, Alessandro Gialluisi, Paramjit Singh Gill, Logan M Glasstetter, Elena V Gnedovskaya, Ali Golchin, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Mansueto Gomes-Neto, Alessandra C Goulart, Anmol Goyal, Richard J Gray, Michal Grivna, Habtamu Alganeh Guadie, Bin Guan, Giovanni Guarducci, Stefano Guicciardi, Damitha Asanga Gunawardane, Hanbing Guo, Bhawna Gupta, Rajeev Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Reyna Alma Gutiérrez, Farrokh Habibzadeh, Vladimir Hachinski, Rasool Haddadi, Mostafa Hadei, Najah R Hadi, Nils Haep, Teklehaimanot Gereziher Haile, Arvin Haj-Mirzaian, Brian J Hall, Rabih Halwani, Sajid Hameed, Mohammad Hamiduzzaman, Ahmad Hammoud, Hannah Han, Nasrin Hanifi, Graeme J Hankey, Md. Abdul Hannan, Junwei Hao, Harapan Harapan, Habtamu Endashaw Hareru, Arief Hargono, Netanja I. Harlianto, Josep Maria Haro, Nicholas Nathaniel Hartman, Ahmed I. Hasaballah, Faizul Hasan, Hamidreza Hasani, Mohammad Hasanian, Amr Hassan, Shoaib Hassan, Soheil Hassanipour, Hadi Hassankhani, Mohammed Bheser Hassen, Johannes Haubold, Simon I Hay, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Mohammad Heidari, Reza Heidari-Soureshjani, Hamed Hesami, Kamal Hezam, Yuta Hiraike, Howard J Hoffman, Ramesh Holla, Kathleen Pillsbury Hopf, Nobuyuki Horita, Md Mahbub Hossain, Md. Belal Hossain, Sahadat Hossain, Hassan Hosseinzadeh, Mehdi Hosseinzadeh, Sorin Hostiuc, Chengxi Hu, Junjie Huang, Md. Nazmul Huda, Javid Hussain, Nawfal R Hussein, Hong-Han Huynh, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Mehran Ilaghi, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Farideh Iravanpour, Sheikh Mohammed Shariful Islam, Faisal Ismail, Hiroyasu Iso, Gaetano Isola, Masao Iwagami, Chidozie C D Iwu, Mahalaxmi Iyer, Ali Jaan, Louis Jacob, Farhad Jadidi-Niaragh, Mahboobeh Jafari, Morteza Jafarinia, Abdollah Jafarzadeh, Kasra Jahankhani, Nader Jahanmehr, Haitham Jahrami, Abhishek Jaiswal, Mihajlo Jakovljevic, Roland Dominic G Jamora, Somnath Jana, Nilofer Javadi, Saad Javed, Saad Javeed, Sathish Kumar Jayapal, Shubha Jayaram, Heng Jiang, Catherine Owens Johnson, Walter D Johnson, Mohammad Jokar, Jost B Jonas, Abel Joseph, Nitin Joseph, Charity Ehimwenma Joshua, Mikk Jürisson, Ali Kabir, Zubair Kabir, Gebisa Guyasa Kabito, Vidya Kadashetti, Fatemeh Kafi, Rizwan Kalani, Farnaz Kalantar, Feroze Kaliyadan, Ashwin Kamath, Sagarika Kamath, Tanuj Kanchan, Amit Kandel, Himal Kandel, Kehinde Kazeem Kanmodi, Mehrdad Karajizadeh, Jafar Karami, Shama D Karanth, Ibraheem M Karaye, André Karch, Aliasghar Karimi, Hanie Karimi, Arman Karimi Behnagh, Hengameh Kasraei, Nicholas J Kassebaum, Joonas H Kauppila, Harkiran Kaur, Navjot Kaur, Gbenga A Kayode, Foad Kazemi, Leila Keikavoosi-Arani, Cathleen Keller, Mohammad Keykhaei, Mohammad Amin Khadembashiri, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Himanshu Khajuria, Amirmohammad Khalaji, Faham Khamesipour, Mohammad Khammarnia, Maseer Khan, Moien AB Khan, Yusra H Khan, Mahammed Ziauddin Khan Suheb, Shaghayegh Khanmohammadi, Tripti Khanna, Khaled Khatab, Haitham Khatatbeh, Moawiah Mohammad Khatatbeh, Sorour Khateri, Mahalaqua Nazli Khatib, Hamid Reza Khayat Kashani, Mohammad Saeid Khonji, Fatemeh khorashadizadeh, Moein Khormali, Jagdish Khubchandani, Saeid Kian, Grace Kim, Jihee Kim, Min Seo Kim, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Sonali Kochhar, Ali-Asghar Kolahi, Kamrun Nahar Koly, Farzad Kompani, Walter J Koroshetz, Soewarta Kosen, Masoumeh Kourosh Arami, Ai Koyanagi, Michael A Kravchenko, Kewal Krishan, Vijay Krishnamoorthy, Barthelemy Kuate Defo, Md Abdul Kuddus, Ashish Kumar, G Anil Kumar, Manasi Kumar, Nithin Kumar, Netsanet Bogale Kumsa, Satyajit Kundu, Maria Dyah Kurniasari, Dian Kusuma, Ambily Kuttikkattu, Hmwe Hmwe Kyu, Carlo La Vecchia, Muhammad Awwal Ladan, Chandrakant Lahariya, Tri Laksono, Dharmesh Kumar Lal, Tea Lallukka, Judit Lám, Faris Hasan Lami, Iván Landires, Berthold Langguth, Savita Lasrado, Kamaluddin Latief, Kaveh Latifinaibin, Kathryn Mei-Ming Lau, Matthew B Laurens, Basira Kankia Lawal, Long Khanh Dao Le, Thao Thi Thu Le, Caterina Ledda, Munjae Lee, Sang-woong Lee, Seung Won Lee, Wei-Chen Lee, Yo Han Lee, Matilde Leonardi, Temesgen L Lerango, Ming-Chieh Li, Wei Li, Virendra S Ligade, Stephen S Lim, Christine Linehan, Chaojie Liu, Jue Liu, Wei Liu, Chun-Han Lo, Warren David Lo, Stany W Lobo, Giancarlo Logroscino, Graciliana Lopes, Platon D Lopukhov, László Lorenzovici, Stefan Lorkowski, Joana A Loureiro, Jailos Lubinda, Giancarlo Lucchetti, Ricardo Lutzky Saute, Zheng Feei Ma, Mahmoud Mabrok, Monika Machoy, Farzan Madadizadeh, Mohammed Magdy Abd El Razek, Azzam A Maghazachi, Nastaran Maghbouli, Soleiman Mahjoub, Morteza Mahmoudi, Azeem Majeed, Jeadran N. 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Ashraf Mohamadkhani, Nouh Saad Mohamed, Esmaeil Mohammadi, Hiwa Mohammadi, Shadieh Mohammadi, Soheil Mohammadi, Marita Mohammadshahi, Mustapha Mohammed, Salahuddin Mohammed, Shafiu Mohammed, Syam Mohan, Hoda Mojiri-forushani, Nagabhishek Moka, Ali H Mokdad, Sabrina Molinaro, Holger Möller, Lorenzo Monasta, Md Moniruzzaman, Fateme Montazeri, Maryam Moradi, Yousef Moradi, Maziar Moradi-Lakeh, Paula Moraga, Negar Morovatdar, Shane Douglas Morrison, Abbas Mosapour, Jonathan F Mosser, Elias Mossialos, Majid Motaghinejad, Parsa Mousavi, Seyed Ehsan Mousavi, Sumaira Mubarik, Lorenzo Muccioli, Faraz Mughal, George Duke Mukoro, Admir Mulita, Francesk Mulita, Fungai Musaigwa, Ahmad Mustafa, Ghulam Mustafa, Sathish Muthu, Ahamarshan Jayaraman Nagarajan, Pirouz Naghavi, Ganesh R Naik, Firzan Nainu, Tapas Sadasivan Nair, Hastyar Hama Rashid Najmuldeen, Noureddin Nakhostin Ansari, Gopal Nambi, Hossein Namdar Areshtanab, Shumaila Nargus, Bruno Ramos Nascimento, Abdallah Y Naser, Abdulqadir J J Nashwan, Hadis Nasoori, Ahmed Nasreldein, Zuhair S Natto, Javaid Nauman, Biswa Prakash Nayak, Athare Nazri-Panjaki, Mohammad Negaresh, Hadush Negash, Ionut Negoi, Ruxandra Irina Negoi, Serban Mircea Negru, Seyed Aria Nejadghaderi, Mohammad Hadi Nematollahi, Olivia D Nesbit, Charles Richard James Newton, Dang H Nguyen, Hau Thi Hien Nguyen, Hien Quang Nguyen, Ngoc-Trinh Thi Nguyen, Phat Tuan Nguyen, Van Thanh Nguyen, Robina Khan Niazi, Taxiarchis Konstantinos Nikolouzakis, Vikram Niranjan, Lawrence Achilles Nnyanzi, Efaq Ali Noman, Nafise Noroozi, Bo Norrving, Jean Jacques Noubiap, Chisom Adaobi Nri-Ezedi, George Ntaios, Virginia Nuńez-Samudio, Dieta Nurrika, Bogdan Oancea, Ismail A Odetokun, Martin James O'Donnell, Ropo Ebenezer Ogunsakin, James Odhiambo Oguta, In-Hwan Oh, Hassan Okati-Aliabad, Sylvester Reuben Okeke, Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Patrick Godwin Okwute, Andrew T Olagunju, Muideen Tunbosun Olaiya, Matifan Dereje Olana, Matthew Idowu Olatubi, Gláucia Maria Moraes Oliveira, Isaac Iyinoluwa Olufadewa, Bolajoko Olubukunola Olusanya, Ahmed Omar Bali, Sokking Ong, Obinna E Onwujekwe, Michal Ordak, Aislyn U Orji, Doris V Ortega-Altamirano, Uchechukwu Levi Osuagwu, Nikita Otstavnov, Stanislav S Otstavnov, Amel Ouyahia, Mayowa O Owolabi, Mahesh Padukudru P A, Kevin Pacheco-Barrios, Jagadish Rao Padubidri, Pramod Kumar Pal, Padmavali Nanaji Palange, Claudia Palladino, Raffaele Palladino, Raul Felipe Palma-Alvarez, Feng Pan, Demosthenes Panagiotakos, Songhomitra Panda-Jonas, Anamika Pandey, Ashok Pandey, Jeyaraj Durai Pandian, Helena Ullyartha Pangaribuan, Ioannis Pantazopoulos, Shahina Pardhan, Pragyan Paramita Parija, Romil R Parikh, Seoyeon Park, Ashwaghosha Parthasarathi, Ava Pashaei, Jay Patel, Shankargouda Patil, Dimitrios Patoulias, Shrikant Pawar, Paolo Pedersini, Umberto Pensato, David M Pereira, Jeevan Pereira, Maria Odete Pereira, Mario F P Peres, Norberto Perico, Simone Perna, Ionela-Roxana Petcu, Fanny Emily 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Amin Sharifan, Manoj Sharma, Rajesh Sharma, Bereket Beyene Shashamo, Maryam Shayan, Rahim Ali Sheikhi, Shashank Shekhar, Jiabin Shen, Suchitra M Shenoy, Pavanchand H Shetty, Desalegn Shiferaw Shiferaw, Mika Shigematsu, Rahman Shiri, Aminu Shittu, K M Shivakumar, Fereshteh Shokri, Sina Shool, Seyed Afshin Shorofi, Sunil Shrestha, Akhenaten Benjamin Siankam Tankwanchi, Emmanuel Edwar Siddig, Inga Dora Sigfusdottir, João Pedro Silva, Luís Manuel Lopes Rodrigues Silva, Ehsan Sinaei, Balbir Bagicha Singh, Garima Singh, Paramdeep Singh, Surjit Singh, Sarah Brooke Sirota, Shravan Sivakumar, Abdullah Al Mamun Sohag, Ranjan Solanki, Hamidreza Soleimani, Solikhah Solikhah, Yerukneh Solomon, Yonatan Solomon, Suhang Song, Yimeng Song, Houman Sotoudeh, Michael Spartalis, Benjamin A Stark, Joseph R Starnes, Antonina V Starodubova, Dan J Stein, Timothy J Steiner, Lars Jacob Stovner, Muhammad Suleman, Rizwan Suliankatchi Abdulkader, Abida Sultana, Jing Sun, David Sunkersing, Angel Sunny, Hani 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Girma Tufa, Chukwudi S Ubah, Aniefiok John Udoakang, Inam Ulhaq, Muhammad Umair, Srikanth Umakanthan, Krishna Kishore Umapathi, Brigid Unim, Bhaskaran Unnikrishnan, Asokan Govindaraj Vaithinathan, Alireza Vakilian, Sahel Valadan Tahbaz, Rohollah Valizadeh, Jef Van den Eynde, Priya Vart, Shoban Babu Varthya, Tommi Juhani Vasankari, Siavash Vaziri, Balachandar Vellingiri, Narayanaswamy Venketasubramanian, Georgios-Ioannis Verras, Dominique Vervoort, Jorge Hugo Villafańe, Leonardo Villani, Andres Fernando Vinueza Veloz, Maria Viskadourou, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Simona Ruxandra Volovat, Loc Tri Vu, Isidora S Vujcic, Birhanu Wagaye, Yasir Waheed, Waseem Wahood, Mandaras Tariku Walde, Fang Wang, Shu Wang, Yanzhong Wang, Yuan-Pang Wang, Muhammad Waqas, Abdul Waris, Kosala Gayan Weerakoon, Robert G Weintraub, Abrha Hailay Weldemariam, Ronny Westerman, Joanna L Whisnant, Dakshitha Praneeth Wickramasinghe, Nuwan Darshana Wickramasinghe, Barbara Willekens, Lauren B Wilner, Andrea Sylvia Winkler, Charles D A Wolfe, Ai-Min Wu, Sarah Wulf Hanson, Suowen Xu, Xiaoyue Xu, Ali Yadollahpour, Sajad Yaghoubi, Galal Yahya, Kazumasa Yamagishi, Lin Yang, Yuichiro Yano, Yao Yao, Sisay Shewasinad Yehualashet, Alex Yeshaneh, Metin Yesiltepe, Siyan Yi, Arzu Yiğit, Vahit Yiğit, Dong Keon Yon, Naohiro Yonemoto, Yuyi You, Mustafa Z Younis, Chuanhua Yu, Hadiza Yusuf, Siddhesh Zadey, Mohammad Zahedi, Fathiah Zakham, Nazar Zaki, Alireza Zali, Giulia Zamagni, Ramin Zand, Ghazal G Z Zandieh, Moein Zangiabadian, Amin Zarghami, Mikhail Sergeevich Zastrozhin, Mohammed G M Zeariya, Zelalem Banjaw Zegeye, Francis Zeukeng, Chunxia Zhai, Chen Zhang, Haijun Zhang, Yunquan Zhang, Zhi-Jiang Zhang, Hanqing Zhao, Yang Zhao, Peng Zheng, Hengxing Zhou, Bin Zhu, Abzal Zhumagaliuly, Magdalena Zielińska, Yossef Teshome Zikarg, Mohammad Zoladl, Christopher J L Murray, Kanyin Liane Ong, Valery L Feigin, Theo Vos, Tarun Dua
Journal: The Lancet Neurology (2024)

<h2>Summary</h2><h3>Background</h3> 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. <h3>Methods</h3> 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. <h3>Findings</h3> 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 rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. <h3>Interpretation</h3> As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. <h3>Funding</h3> Bill & Melinda Gates Foundation.