{
  "abstract": "Background: Huntington disease (HD) develops years before it is formally recorded, yet whether this generates measurable healthcare demand, and when, is unknown. We aimed to determine when trajectories of incident HD diverge from matched controls. Methods: Retrospective matched cohort study using the French National Health Data System. Adults with incident HD (2018 to 2024; ≥2 hospital visits or ≥1 long-term registration for nternational Classification of Diseases, 10th Revision (ICD-10) G10 or F02.2; no HD code in the prior 9 years) were each matched to five controls on sex, age and deprivation. Recurrent events were modelled from 9 years before to 7 years after the first HD record. Results: Among 2659 cases and 13 295 controls, divergence preceded the first record by 6 to 8 years. Antipsychotic use rose earliest (8 years prior, HR 1.54, 95% CI 1.31 to 1.80). From 6 years prior, neurology (HR 1.53, 95% CI 1.06 to 2.22), psychiatry (HR 1.25, 95% CI 1.04 to 1.47) and speech therapy (HR 2.16, 95% CI 1.46 to 3.19) diverged. Before the record, neurology consultations occurred in 50.8% of cases versus 10.0% of controls, psychiatry consultations in 33.9% vs 10.0% and speech therapy in 8.5% vs 0.6%. After the record, divergence widened: neurology peaked at 3 years (HR 5.44, 95% CI 3.94 to 7.54) and antipsychotic use at 5 years (HR 3.63, 95% CI 3.06 to 4.30), while physiotherapy emerged only afterwards (4 years, HR 3.10, 95% CI 2.89 to 3.33). Conclusions: HD generates substantial care years before diagnostic coding. Neuropsychiatric and communicative demand precedes motor-related rehabilitative care by several years, defining a measurable window for earlier referral.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "Marc Dibling"
    },
    {
      "name": "Anna Heinzmann"
    },
    {
      "name": "Claire Ewenczyk"
    },
    {
      "name": "Alexandra Durr"
    },
    {
      "name": "Sophie Tezenas Du Montcel"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6ac98ad5te8kk.bib",
  "cited_by": 0,
  "doi": "10.1136/jnnp-2026-339550",
  "fulltext_url": null,
  "id": "6ac98ad5te8kk",
  "issns": [
    "0022-3050",
    "1468-330X"
  ],
  "landing_url": "https://hal.science/hal-05839771v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.neu"
    ],
    [
      "hal",
      "1.sdv.spee"
    ],
    [
      "openalex",
      "2804|Genetic Neurodegenerative Diseases"
    ]
  ],
  "openalex": "W7223244705",
  "pdf_url": "https://hal.science/hal-05839771/document",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-22",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/6ac98ad5te8kk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:01Z",
      "native_id": "hal-05839771",
      "source": "hal",
      "url": "https://hal.science/hal-05839771v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:1.sdv.neu",
      "subfield": "neuroscience"
    },
    {
      "field": "medicine",
      "origin": "hal:1.sdv.spee",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Healthcare trajectories diverge years before Huntington disease is recorded in claims: a nationwide French matched cohort study",
  "title_text": "Healthcare trajectories diverge years before Huntington disease is recorded in claims: a nationwide French matched cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:01Z",
  "url": "https://research.draconitic.com/paper/6ac98ad5te8kk",
  "venue": "Journal of Neurology, Neurosurgery and Psychiatry",
  "versions": []
}