Healthcare trajectories diverge years before Huntington disease is recorded in claims: a nationwide French matched cohort study

People with Huntington disease (HD) use more hospital, psychiatric, neurological and allied-health services than the general population, and cognitive and behavioural changes are recognised to precede motor diagnosis. However, this evidence comes largely from clinic cohorts or from utilisation measured after diagnosis, at single time points, leaving it unclear when healthcare trajectories first diverge from the general population and whether a measurable prediagnosis period of HD-relevant care exists in real-world data.

Using nationwide French claims data on 2659 incident cases and 13 295 matched controls, we show that healthcare demand diverges 6 to 8 years before HD is first recorded, driven first by antipsychotic prescribing, then psychiatric, neurology and speech-therapy care, whereas physiotherapy rises only after the record. This ordering, with neuropsychiatric and communicative needs preceding motor-related rehabilitation by several years, is demonstrated for the first time at national scale...