The Burden of Motor Neuron Diseases in the United States, 1990-2021: A Systematic Analysis of the Global Burden of Disease Study 2021.
Level 4 - case-series / case-control
Descriptive epidemiological modeling study (secondary analysis of GBD 2021 data).
PubMed 40927826 · doi:10.1002/mus.70023
What was done
Secondary analysis of the Global Burden of Disease (GBD) 2021 dataset evaluating prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for motor neuron diseases (MNDs) in the United States from 1990 to 2021. Estimates were modeled using DisMod-MR 2.1 Bayesian meta-regression and stratified by age group, sex, geographic region, and sociodemographic index (SDI).
What was found
In 2021, the US age-standardized prevalence rate for MNDs was 8.82 (95% uncertainty interval [UI], 7.96–9.74) per 100,000, representing a 12.89% (95% UI, 3.10%–23.66%) increase from 7.82 per 100,000 in 1990. The age-standardized mortality rate in 2021 was 1.49 (95% UI, 1.38–1.56) per 100,000, an 18.34% (95% UI, 13.86%–22.70%) increase compared to 1990. Age-standardized MND-related DALY rate in 2021 was 41.36 (95% UI, 39.47–42.94) per 100,000, up 4.14% (95% UI, 0.41%–7.68%) from 1990. Burden was consistently greater in males (male-to-female ratio ~1.4:1). Geographically, the West North Central region had the highest DALY rates and the Middle Atlantic the lowest. SDI was negatively correlated with age-standardized DALYs, years of life lost, and mortality.
Why it matters
This study provides updated national benchmark estimates demonstrating a substantial 30-year rise in US motor neuron disease burden alongside persistent regional and socioeconomic disparities.
Limits
The findings rely on Bayesian meta-regression modeling from existing datasets rather than direct primary surveillance. MND subtypes were not reported separately in the abstract, and longitudinal trends may partly reflect historical changes in diagnostic coding, case ascertainment, and awareness rather than true biological increases.
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