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How much headache is there in the world? The answer depends on how headache is measured. The question, however, is an important one. It is at the basis of health policy, prioritisation and the due allocation of health resources to headache care and the mitigation of its clinical sequelae. From this perspective, prevalence alone is not highly informative: it is the burdens arising from headache disorders that dictate their impact on public health. These burdens are multiple, diverse and partly invisible [1]. Methods do not yet exist to measure them all [1], but the focus meanwhile has been on disability. It is to this, primarily, that health, quality of life, productivity and financial security are hostage. So how much headache-related disability is there in the world? Estimates of disability due to disease are a principal objective of the Global Burden of Disease (GBD) studies, performed reiteratively since 1990 and described now as “the most comprehensive worldwide observational epidemiological study to date” [2]. GBD 1990 was initiated by the World Bank and GBD 2000 by the World Health Organization; subsequently, GBD has been led by the Institute for Health Metrics and Evaluation [3], and financially supported by the Bill and Melinda Gates Foundation. GBD uses a number of metrics: among these, disability is measured in years lived with disability (YLDs) and early mortality in years of life lost (YLLs); disability-adjusted life years (DALYs) are the summation of YLDs and YLLs. Migraine first featured in GBD 2000 [4], and over 13 years ascended the ranks of top causes of YLDs worldwide, from 19 in GBD 2000 [4] to seventh in GBD 2010 [5, 6] and sixth in GBD

GBD 2015: migraine is the third cause of disability in under 50s