Assessing the social determinants of health in Tourette Syndrome

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. Disclosure: Dr. Dy has nothing to disclose. Dr. Osiecki has nothing to disclose. Dr. Essa has nothing to disclose. Dr. Mathews has nothing to disclose. Dr. Mejia has nothing to disclose. Dr. Scharf has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Abide Therapeutics.