RESEARCH SUBMISSION

Prevalence and burden of migraine in the United States: A systematic review

Fred Cohen MD

Corresponding Author

Fred Cohen MD

Mount Sinai Center for Headache and Facial Pain, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA

Correspondence

Fred Cohen, Mount Sinai Center for Headache and Facial Pain, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Email: [email protected]

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Caroline V. Brooks MA

Caroline V. Brooks MA

Department of Sociology, Indiana University, Bloomington, Indiana, USA

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Daniel Sun BS

Daniel Sun BS

Department of Neurology, Montefiore Medical Center, Bronx, New York, USA

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Dawn C. Buse PhD

Dawn C. Buse PhD

Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA

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Michael L. Reed PhD

Michael L. Reed PhD

Vedanta Research, Chapel Hill, North Carolina, USA

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Kristina M. Fanning PhD

Kristina M. Fanning PhD

Vedanta Research, Chapel Hill, North Carolina, USA

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Richard B. Lipton MD

Richard B. Lipton MD

Department of Neurology, Montefiore Medical Center, Bronx, New York, USA

Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA

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First published: 03 May 2024

Abstract

Background

This study reviewed migraine prevalence and disability gathered through epidemiologic survey studies in the United States conducted over the past three decades. We summarized these studies and evaluated changing patterns of disease prevalence and disability.

Methods

We conducted a systematic review of US studies addressing the prevalence, disability, and/or burden of migraine, including both episodic migraine (EM) and chronic migraine (CM). A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used in conjunction with the PubMed search engine. Eligible studies were published before February 2022, were conducted in the United States, included representative samples, and used a case definition of migraine based on the International Classification of Headache Disorders (ICHD). The primary measure of disease burden was the Migraine Disability Assessment Scale (MIDAS). The MIDAS measures days lost due to migraine over 3 months in three domains and defines groups with moderate (Grade III) or severe disability (Grade IV) using cut-scores.

Results

Of the 1609 identified records, 26 publications from 11 US population-based studies met eligibility criteria. The prevalence of migraine in the population has remained relatively consistent for the past 30 years: ranging from 11.7% to 14.7% overall, 17.1% to 19.2% in women, and 5.6% to 7.2% in men in the studies reviewed. CM prevalence is 0.91% (1.3% among women and 0.5% of men) in adults and 0.8% in adolescents. The proportion of people with migraine and moderate-to-severe MIDAS disability (Grades III–IV), has trended upward across studies from 22.0% in 2005 to 39.0% in 2012, to 43.2% in 2016, and 42.4% in 2018. A consistently higher proportion of women were assigned MIDAS Grades III/IV relative to men.

Conclusion

The prevalence of migraine in the United States has remained stable over the past three decades while migraine-related disability has increased. The disability trend could reflect changes in reporting, study methodology, social and societal changes, or changes in exacerbating or remediating factors that make migraine more disabling, among other hypotheses. These issues merit further investigation.

CONFLICT OF INTEREST STATEMENT

Fred Cohen serves as an assistant editor for Headache. He has received honoraria from Springer Nature and Medlink Neurology.

Caroline Brooks has no disclosures to report.

Daniel Sun has no disclosures to report.

Dawn Buse has been a consultant and/or received research funding from Abbvie/Allergan, Amgen, Biohaven, Collegium, GSK, Lilly, Lundbeck, and Teva. Work supported by Abbvie/Allergan, Lilly, and OrthoMcNeil is reviewed in this manuscript.

Michael Reed is the Managing Director of Vedanta Research, which has received research funding from AbbVie, Allay Lamp, Dr. Reddy's Laboratories, Eli Lilly, and GlaxoSmithKline via grants to the National Headache Foundation.

Christina Fanning is Managing Director of MIST Research which has received research funding from AbbVie, NYU Langone Heal, Allay Lamp, Juva Health, and GlaxoSmithKline via grants to the National Headache Foundation.

Richard Lipton receives research support from the NIH and FDA, as well as the National Headache Foundation and the Marx Foundation. He also receives research support from Allergan/AbbVie, Amgen, Eli Lilly, and Electrocore. He receives personal fees as a consultant or advisor from Allergan/AbbVie, Amgen, Biohaven Holdings, Cooltech, GlaxoSmithKline, Grifols, Heleon, Impel, Eli Lilly, Lundbeck, Merck, Pfizer, and Teva Pharmaceuticals. He holds stock or options in Axon, Biohaven Holdings, CoolTech, and Manistee. In addition, he receives royalties for Wolff's Headache seventh and eighth Edition.