학술논문

Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Document Type
Author
Feigin, Valery L.Nichols, EmmaAlam, TahiyaBannick, Marlena S.Beghi, EttoreBlake, NatachaCulpepper, William J.Dorsey, E. RayElbaz, AlexisEllenbogen, Richard G.Fisher, James L.Fitzmaurice, ChristinaGiussani, GiorgiaGlennie, LindaJames, Spencer L.Johnson, Catherine OwensKassebaum, Nicholas J.Logroscino, GiancarloMarin, BenoitMountjoy-Venning, W. CliffNguyen, MinhOfori-Asenso, RichardPatel, Anoop P.Piccininni, MarcoRoth, Gregory A.Steiner, Timothy J.Stovner, Lars JacobSzoeke, Cassandra E. I.Theadom, AliceVollset, Stein EmilWallin, Mitchell TaylorWright, ClaireZunt, Joseph RaymondAbbasi, NooshinAbd-Allah, FoadAbdelalim, AhmedAbdollahpour, IbrahimAboyans, VictorAbraha, Haftom NiguseAcharya, DilaramAdamu, Abdu A.Adebayo, Oladimeji M.Adeoye, Abiodun MoshoodAdsuar, Jose C.Afarideh, MohsenAgrawal, SutapaAhmadi, AlirezaAhmed, Muktar BeshirAichour, Amani NidhalAichour, IbtihelAichour, Miloud Taki EddineAkinyemi, Rufus OlusolaAkseer, NadiaAl-Eyadhy, AymanSalman, Rustam Al-ShahiAlahdab, FaresAlene, Kefyalew AddisAljunid, Syed MohamedAltirkawi, KhalidAlvis-Guzman, NelsonAnber, Nahla HamedAntonio, Carl Abelardo T.Arabloo, JalalAremu, OlatundeArnlov, JohanAsayesh, HamidAsghar, Rana JawadAtalay, Hagos TasewAwasthi, AshishAyala Quintanilla, Beatriz PaulinaAyuk, Tambe B.Badawi, AlaaBanach, MaciejBanoub, Joseph Adel MattarBarboza, Miguel A.Barker-Collo, Suzanne LynBarnighausen, Till WinfriedBaune, Bernhard T.Bedi, NeerajBehzadifar, MasoudBehzadifar, MeysamBejot, YannickBekele, Bayu BegashawBelachew, Abate BekeleBennett, Derrick A.Bensenor, Isabela M.Berhane, AdugnawBeuran, MirceaBhattacharyya, KrittikaBhutta, Zulfiqar A.Biadgo, BeleteBijani, AliBililign, NigusBin Sayeed, Muhammad ShahdaatBlazes, Christopher KynrintBrayne, CarolButt, Zahid A.Campos-Nonato, Ismael R.Cantu-Brito, CarlosCar, MateCardenas, RosarioCarrero, Juan J.Carvalho, FelixCastaneda-Orjuela, Carlos A.Castro, FranzCatala-Lopez, FerranCerin, EsterChaiah, YazanChang, Jung-ChenChatziralli, IriniChiang, Peggy Pei-ChiaChristensen, HanneChristopher, Devasahayam J.Cooper, CyrusCortesi, Paolo AngeloCosta, Vera M.Criqui, Michael H.Crowe, Christopher StephenDamasceno, Albertino Antonio MouraDaryani, AhmadDe la Cruz-Gongora, VanessaPio De la Hoz, FernandoDe Leo, DiegoDegefa, Meaza GirmaDemoz, Gebre TeklemariamDeribe, KebedeDharmaratne, Samath DhammindaDiaz, DanielDinberu, Mesfin TadeseDjalalinia, ShirinDoku, David TeyeDubey, ManishaDubljanin, EleonoraDuken, Eyasu EjetaEdvardsson, DavidEl-Khatib, ZiadEndres, MatthiasEndries, Aman YesufEskandarieh, ShararehEsteghamati, AlirezaEsteghamati, SadafFarhadi, FarzanehFaro, AndreFarzadfar, FarshadFarzaei, Mohammad HoseinFatima, BatoolFereshtehnejad, Seyed-MohammadFernandes, EduardaFeyissa, Garumma ToluFilip, IrinaFischer, FlorianFukumoto, TakeshiGanji, MorsalehGankpe, Fortune GbetohoGarcia-Gordillo, Miguel A.Gebre, Abadi KahsuGebremichael, Teklu GebrehiwoGelaw, Belayneh K.Geleijnse, Johanna M.Geremew, DemekeGezae, Kebede EmbayeGhasemi-Kasman, MaryamGidey, Mahari Y.Gill, Paramjit SinghGill, Tiffany K.Gnedovskaya, Elena V.Goulart, Alessandra C.Grada, AymanGrosso, GiuseppeGuo, YumingGupta, RahulGupta, RajeevHaagsma, Juanita A.Hagos, Tekleberhan B.Haj-Mirzaian, ArvinHaj-Mirzaian, AryaHamadeh, Randah R.Hamidi, SamerHankey, Graeme J.Hao, YuantaoHaro, Josep MariaHassankhani, HadiHassen, Hamid YimamHavmoeller, RasmusHay, Simon I.Hegazy, Mohamed I.Heidari, BehnamHenok, AndualemHeydarpour, FatemehHoang, Chi LinhHole, Michael K.Rad, Enayatollah HomaieHosseini, Seyed MostafaHu, GuoqingIgumbor, Ehimario U.Ilesanmi, Olayinka StephenIrvani, Seyed Sina NaghibiIslam, Sheikh Mohammed SharifulJakovljevic, MihajloJavanbakht, MehdiJha, Ravi PrakashJobanputra, Yash B.Jonas, Jost B.Jozwiak, Jacek JerzyJurisson, MikkKahsay, AmahaKalani, RizwanKalkonde, YogeshwarKamil, Teshome AbegazKanchan, TanujKarami, ManoochehrKarch, AndreKarimi, NargesKasaeian, AmirKassa, Tesfaye DessaleKassa, Zemenu YohannesKaul, AnilKefale, Adane TeshomeKeiyoro, Peter NjengaKhader, Yousef SalehKhafaie, Morteza AbdullatifKhalil, Ibrahim A.Khan, Ejaz AhmadKhang, Young-HoKhazaie, HabibolahKiadaliri, Aliasghar A.Kiirithio, Daniel N.Kim, Anthony S.Kim, DanielKim, Young-EunKim, Yun JinKisa, AdnanKokubo, YoshihiroKoyanagi, AiKrishnamurthi, Rita V.Defo, Barthelemy KuateBicer, Burcu KucukKumar, ManasiLacey, BenLafranconi, AlessandraLansingh, Van C.Latifi, ArmanLeshargie, Cheru TesemaLi, ShanshanLiao, YuLinn, ShaiLo, Warren DavidLopez, Jaifred Christian F.Lorkowski, StefanLotufo, Paulo A.Lucas, Robyn M.Lunevicius, RaimundasMackay, Mark T.Mahotra, Narayan BahadurMajdan, MarekMajdzadeh, RezaMajeed, AzeemMalekzadeh, RezaMalta, Deborah CarvalhoManafi, NavidMansournia, Mohammad AliMantovani, Lorenzo GiovanniMarz, WinfriedMashamba-Thompson, Tivani PhosaMassenburg, Benjamin BallardMate, Kedar K. V.McAlinden, ColmMcGrath, John J.Mehta, VarshilMeier, ToniMeles, Hagazi GebreMelese, AddisuMemiah, Peter T. N.Memish, Ziad A.Mendoza, WalterMengistu, Desalegn TadeseMengistu, GetnetMeretoja, AtteMeretoja, Tuomo J.Mestrovic, TomislavMiazgowski, BartoszMiazgowski, TomaszMiller, Ted R.Mini, G. K.Mirrakhimov, Erkin M.Moazen, BabakMohajer, BahramMezerji, Naser Mohammad GholiMohammadi, MoslemMohammadi-Khanaposhtani, MaryamMohammadibakhsh, RoghayehMohammadnia-Afrouzi, MousaMohammed, ShafiuMohebi, FarnamMokdad, Ali H.Monasta, LorenzoMondello, StefaniaMoodley, YoshanMoosazadeh, MahmoodMoradi, GhobadMoradi-Lakeh, MaziarMoradinazar, MehdiMoraga, PaulaVelasquez, Ilais MorenoMorrison, Shane DouglasMousavi, Seyyed MeysamMuhammed, Oumer SadaMuruet, WalterMusa, Kamarul ImranMustafa, GhulamNaderi, MehdiNagel, GabrieleNaheed, AliyaNaik, GurudattaNajafi, FaridNangia, VinayNegoi, IonutNegoi, Ruxandra IrinaNewton, Charles Richard JamesNgunjiri, Josephine W.Nguyen, Cuong TatNguyen, Long HoangNingrum, Dina Nur AnggrainiNirayo, Yirga LegesseNixon, Molly R.Norrving, BoNoubiap, Jean JacquesShiadeh, Malihe NourollahpourNyasulu, Peter S.Ogbo, Felix AkpojeneOh, In-HwanOlagunju, Andrew T.Olagunju, Tinuke O.Olivares, Pedro R.Onwujekwe, Obinna E.Oren, EyalOwolabi, Mayowa OjoMahesh, P. A.Pakpour, Amir H.Pan, Wen-HarnPanda-Jonas, SonghomitraPandian, Jeyaraj DuraiPatel, Sangram KishorPereira, David M.Petzold, MaxPillay, Julian DavidPiradov, Michael A.Polanczyk, Guilherme V.Polinder, SuzannePostma, Maarten J.Poulton, RichiePoustchi, HosseinPrakash, SwayamPrakash, V.Qorbani, MostafaRadfar, AmirRafay, AnwarRafiei, AlirezaRahim, FakherRahimi-Movaghar, VafaRahman, MahfuzarRahman, Mohammad Hifz UrRahman, Muhammad AzizRajati, FatemehRam, UshaRanta, AnnaRawaf, David LaithRawaf, SalmanReinig, NickolasReis, CesarRenzaho, Andre M. N.Resnikoff, SergeRezaeian, ShahabRezai, Mohammad SadeghGonzalez, Carlos Miguel RiosRoberts, Nicholas L. S.Roever, LeonardoRonfani, LucaRoro, Elias MerdassaRoshandel, GholamrezaRostami, AliSabbagh, ParisaSacco, Ralph L.Sachdev, Perminder S.Saddik, BasemaSafari, HoseinSafari-Faramani, RoyaSafi, SareSafiri, SaeidSagar, RajeshSahathevan, RameshSahebkar, AmirhosseinSahraian, Mohammad AliSalamati, PaymanZahabi, Saleh SalehiSalimi, YahyaSamy, Abdallah M.Sanabria, JuanSantos, Itamar S.Milicevic, Milena M. SantricSarrafzadegan, NizalSartorius, BennSarvi, ShahabeddinSathian, BrijeshSatpathy, MaheswarSawant, Arundhati R.Sawhney, MonikaSchneider, Ione J. C.Schottker, BenSchwebel, David C.Seedat, SorayaSepanlou, Sadaf G.Shabaninejad, HoseinShafieesabet, AzadehShaikh, Masood AliShakir, Raad A.Shams-Beyranvand, MehranShamsizadeh, MortezaSharif, MehdiSharif-Alhoseini, MahdiShe, JunSheikh, AzizSheth, Kevin N.Shigematsu, MikaShiri, RahmanShirkoohi, RezaShiue, IvySiabani, SorayaSiddiqi, Tariq J.Sigfusdottir, Inga DoraSigurvinsdottir, RannveigSilberberg, Donald H.Silva, Joao PedroSilveira, Dayane Gabriele AlvesSingh, Jasvinder A.Sinha, Dhirendra NarainSkiadaresi, EiriniSmith, MariSobaih, Badr HasanSobhani, SoheilaSoofi, MoslemSoyiri, Ireneous N.Sposato, Luciano A.Stein, Dan J.Stein, Murray B.Stokes, Mark A.Sufiyan, Mu'awiyyah BabaleSykes, Bryan L.Sylaja, PnTabares-Seisdedos, RafaelAo, Braden James TeTehrani-Banihashemi, ArashTemsah, Mohamad-HaniTemsah, OmarThakur, Jarnail SinghThrift, Amanda G.Topor-Madry, RomanTortajada-Girbes, MiguelTovani-Palone, Marcos RobertoTran, Bach XuanTran, Khanh BaoTruelsen, Thomas ClementTsadik, Afewerki GebremeskelCar, Lorainne TudorUkwaja, Kingsley NnannaUllah, IrfanUsman, Muhammad ShariqUthman, Olalekan A.Valdez, Pascual R.Vasankari, Tommi JuhaniVasanthan, RajagopalanVeisani, YousefVenketasubramanian, NarayanaswamyViolante, Francesco S.Vlassov, VasilyVosoughi, KiaVu, Giang ThuVujcic, Isidora S.Wagnew, Fasil ShiferawWaheed, YasirWang, Yuan-PangWeiderpass, ElisabeteWeiss, JordanWhiteford, Harvey A.Wijeratne, TissaWinkler, Andrea SylviaWiysonge, Charles SheyWolfe, Charles D. A.Xu, GelinYadollahpour, AliYamada, TomohideYano, YuichiroYaseri, MehdiYatsuya, HiroshiYimer, Ebrahim M.Yip, PaulYisma, EngidaYonemoto, NaohiroYousefifard, MahmoudYu, ChuanhuaZaidi, ZoubidaBin Zaman, SojibZamani, MohammadZandian, HamedZare, ZohrehZhang, YunquanZodpey, SanjayNaghavi, MohsenMurray, Christopher J. L.Vos, Theo
Source
Lancet Neurology. 18(5):459-480
Subject
Language
English
ISSN
1474-4422
1474-4465
Abstract
Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable).Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.Funding: Bill & Melinda Gates Foundation.