Abstract Details

Title Assessing the social determinants of health in Tourette Syndrome

Topic Movement Disorders

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-041

Objective

To examine sociodemographic differences among people living with Tourette Syndrome.

Background Tourette Syndrome (TS) occurs in all racial/ethnic groups. There is limited research related to racial/ethnic disparities in TS. This study analyzes racial/ethnic differences in outcomes among TS patients.

Design/Methods Data from 1,008 individuals with TS were extracted from the Tourette Association of America International Consortium for Genetics (TAAICG) database. To be included, individuals had to have completed sex, race, and ethnicity information. Statistical analyses explored the relationship between race/ethnicity and TS patients’ 1) time-to-diagnosis; 2) tic severity; and 3) comorbidity rates.

Results

870 individuals met inclusion criteria (N=195, 22.4% female; N=675, 77.6% male; mean age 20.2 years±14.5). TS symptom onset was 6.21±2.69 years, with time-to-diagnosis 5.43±8.09 years. OCD was present in 55.1% of TS individuals; ADHD was present in 46%. In gender-stratified analysis, time-to-diagnosis in TS (6.64±9.71 vs 5.08±7.54, p=0.058), ADHD (7.66±10.27 vs 4.34±6.75, p=0.06), and OCD (6.63±9.11 vs 5.73±8.30, p=0.51) was delayed in females compared to males. In analyses stratified by ethnicity (Non-Hispanic N=831, Hispanic N=39) and race (White N=802, Non-White N=56), time-to-diagnosis of TS, ADHD, and OCD was longer in non-Hispanic/White compared to Hispanic/Non-White groups (TS time-to-diagnosis: 5.40±8.29 in White vs. 4.42±3.87 in Non-White TS patients (p=0.107)). Comorbid ADHD rates were significantly increased in Hispanics compared to non-Hispanics (61.5% vs. 45.2%, p=0.04), but not in Non-White vs. White subjects (56.4% vs 45.9%, p=0.106). Rates of comorbid OCD were similar across racial and ethnic groups.

Conclusions

Health care disparities appear to be present in TS patients, including delayed diagnoses in females compared to males, and higher rates of comorbid ADHD in Hispanic compared to non-Hispanic individuals. These analyses will be expanded to 3000 individuals in the TAAICG database. Further understanding of the pathways to disparities must be understood to eliminate potential inequities.

Authors/Disclosures
Marisela E. Dy-Hollins, MD, MSCR, FAAN (Massachusetts General Hospital) PRESENTER	The institution of Dr. Dy-Hollins has received research support from CNCDP-K12.
	No disclosure on file
	No disclosure on file
Carol Mathews	The institution of Carol Mathews has received research support from NIH.
Nicte Mejia, MD, MPH, FAAN (Massachusetts General Hospital)	Dr. Mejia has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Mejia has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. The institution of Dr. Mejia has received research support from Biogen Foundation.
Jeremiah M. Scharf, MD, PhD (Massachusetts General Hospital)	The institution of Dr. Scharf has received research support from the TLC Foundation for Body-Focused Repetitive Behaviors. Dr. Scharf has received personal compensation in the range of $500-$4,999 for serving as a Speaker for a TAA/CDC Family Day Symposium with the Tourette Association of America. Dr. Scharf has a non-compensated relationship as a Scientific Advisory Board Member with the Tourette Association of America that is relevant to AAN interests or activities.

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