Hyperostosis frontalis interna in ancient populations from the Carpathian Basin – A possible relationship between lifestyle and risk of development

Abstract Objective The prevalence of hyperostosis frontalis interna (HFI) was examined in different periods of the Carpathian Basin from 4900 BCE to 17th century AD. The study seeks to evaluate temporal changes in HFI and the possible impact of lifestyle on it. Materials The studied material consisted of 4668 crania from Hungary and Serbia. Methods The crania were analyzed employing macroscopic and endoscopic examination. Results In historic periods, sex and age played a pivotal role in HFI development. Among predominantly pastoralist populations of the 5th–8th and 10th centuries, prevalence of HFI was considerably higher than in the medieval populations of the 9th–17th centuries. Conclusions In addition to age and sex, other factors could be implicated in HFI development. The physiological effects of the pastoralist lifestyle and diet on insulin regulation could explain the increased risk of developing HFI in the 5th–8th and 10th-century populations. Significance The study provides the first comprehensive dataset of HFI from different archaeological periods from the Carpathian Basin. It has implications for lifestyle and risk of HFI development in past populations. Limitations The archaeological periods are not equally represented. Suggestions for further research In order to better understand the etiology of HFI, lifestyle factors can be used to elucidate the risk of developing HFI in ancient populations.