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Han et al. European Journal of Medical Research (2025) 30:711 https://doi.org/10.1186/s40001-025-02958-wRESEARCHGlobal, regional, and national epidemiology of neurological disorders and subcategories: incidence and disability-adjusted life years, 1990–2021Shukui Han 1,2† , Meng Chu 1† , Yitao Ren 2 , Ziyu Zhang 2 , Hongru Chen 2 , Yanzi Li 1 , Ruhai Bai 3* and Lin Yang 4* Abstract Objectives To multi-dimensional analyze global trends and inequalities in the burden of neurological disorders (NDs) and subcategories from 1990 to 2021, and provide clues for policymakers to formulate relevant prevention and con-trol strategies.Methods Using data from the Global Burden of Disease Study 2021, we assessed trends in incidence and disability-adjusted life years (DALYs) and estimated the annual percentage change (EAPC) for NDs and their eight subcategories. Cross-country inequalities and decomposition were quantif i ed for DALYs. Analyses were stratif i ed by Socio-Demo-graphic Index (SDI), age, sex, and region.Results Globally, age-standardized incidence (ASIR) and DALY rates (ASDR) remained stable, but marked heterogene-ity existed across subcategories. Tension-type headache (ASIR: 87%) and migraine (ASDR: 40%) dominated burdens in 2021. Parkinson’s disease and migraine exhibited rising trends (ASIR–EAPC: 1.09% and 0.07%; ASDR–EAPC: 0.32% and 0.05%, respectively). Females bore higher burdens for migraine, multiple sclerosis, and Alzheimer’s disease and other dementias, with disparities widening in older age groups. Middle SDI regions, particularly East Asia (EAPC: 0.22%) and China (0.23%), saw accelerating ASIR. ASDR grew fastest in Western Sub-Saharan Africa (0.22%) and Zam-bia (0.62%). Cross-country inequality indices revealed worsening disparities, concentrating burden in high SDI coun-tries, while idiopathic epilepsy persistently clustered in low SDI populations. Population growth (64.21%) and aging (35.33%) drove DALYs increase, with aging disproportionately impacting high- and high–middle SDI regions.Conclusions The burden of NDs demonstrates signif i cant age, sex, and socioeconomic heterogeneity. Prioritizing resource equity and tailored policies is critical to achieving targets. High SDI regions require aging-focused interven-tions, while low/middle SDI regions need population-level strategies.Keywords Neurological disorders, DALYs, Alzheimer’s disease and other dementias, Parkinson’s disease, Idiopathic epilepsy, HeadacheOpen Access© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modif i ed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by- nc- nd/4. 0/.European Journalof Medical ResearchHandling editor: Gonzalo Aranda-Abreu† Shukui Han and Meng Chu are co-f i rst authors.*Correspondence:Ruhai Bairuhaibai@hotmail.comLin Yangjdvascs@126.comFull list of author information is available at the end of the article