The global burden of motor neuron disease: a systematic and additional analysis of global burden disease study 2021

The last 30 years witnessed significant changes in motor neuron disease (MND) epidemiology. Our study aims to explore the trends and inequality of MND, and predict future changes to 2046. We used Global Burden of Disease (GBD) 2021 data and methodologies (including trends, decomposition, inequality, frontier, and prediction) to describe the disease burden of MND of incidence, prevalence, deaths, and disability-adjusted life-years (DALYs). The case number of incidence, prevalence, deaths and DALYs illustrated an upward trend, however, the age-standardized rate (ASR) for these metrics remained stable. There is substantial variability in MND burden across regions and countries, with higher ASR observed in high sociodemographic index (SDI) regions, particularly the United States, Finland, and the United Kingdom. Gender and age differences also contribute to the disease burden, with males and older populations exhibiting higher incidence rates. The age-period-cohort analysis revealed distinct temporal trends of DALYs across age, period, and birth cohort. Decomposition analysis revealed population aging and growth are critical drivers of the increasing burden. Additionally, the cross-country inequality analysis indicates widening disparities in MND burden, particularly in high SDI regions, from 1990 to 2021. Forecasts for 2046 suggest that while the number of deaths and DALYs may decrease, the incidence and prevalence of MND are expected to continue rising. The frontier analysis further reveals significant differences in performance across countries, with certain high-SDI countries like Sweden and the United Kingdom underperform, indicating that socioeconomic advancements may not always translate into lower disease burden. The findings from this study underscore the need for more targeted interventions, better diagnostic practices, and international collaboration to address the growing global burden of MND. These insights offer a significant contribution to understanding the trends and regional disparities associated with MND, aiding in the development of global health strategies and public health policies to mitigate this burden.