Sex Differences in Natural History and Health Outcomes Among Individuals With Tic Disorders.

Objectives: To analyze sex differences in outcomes in Tourette syndrome (TS) and Persistent Motor or Vocal tic disorders (PMVT) in the Tourette Association of America International Consortium for Genetics (TAAICG) dataset.

Methods: The relationship between sex and clinical measures was explored in 2,403 participants (N = 2,109 with TS; N = 294 with PMVT) from the TAAICG dataset using generalized estimating equation regression models, and adjusted for age and family relationships.

Results: Female (vs male) participants with TS (25.5% of the sample) had 0.46 times lower odds of being formally diagnosed clinically with TS before the research study ( < 0.00001), later age at symptom onset (6.5 ± 2.8 vs 6.0 ± 2.7; = 0.001), later age at diagnosis (13.3 ± 11.2 vs 10.7 ± 8.1; = 0.0001), a longer time-to-diagnosis (3 [1, 7] vs 2 [1, 5], = 0.01), and lower tic severity (28.4 ± 9.1 vs 30.7 ± 8.7); < 0.0001). Female (vs male) participants with PMVT (42.9% of the sample) had an earlier age at symptom onset (7.9 ± 3.3 vs 8.9 ± 3.7; = 0.05).

Discussion: Female (vs male) participants with TS are less likely to be formally diagnosed, have later age at symptom onset, later age at diagnosis, and longer time-to-diagnosis. Female (vs male) participants with PMVT have an earlier age at symptom onset. Future research is needed to understand differences longitudinally in TS and PMVT.