title: Mental Health-Related Healthcare Use Following Bilateral Deep Brain Stimulation For Parkinson's Disease.
abstract: BACKGROUND
  The subthalamic nucleus (STN) and the globus pallidus internus (GPi) are both effective targets for deep brain stimulation (DBS) to relieve motor symptoms of Parkinson's disease. However, studies have reported varied effects on mental health-related adverse events and depressed mood following DBS.
  
  
  OBJECTIVE
  The current observational study sought to compare mental health healthcare utilization and costs for three years following STN or GPi DBS.
  
  
  METHODS
  For a cohort of Veterans (n = 161) with Parkinson's disease who participated in a larger multi-site randomized trial, we compared mental health outpatient visits, medication use, inpatient admissions, and associated costs by DBS target site (STN vs. GPi).
  
  
  RESULTS
  Neither group nor time differences were significant for mental health outpatient or inpatient utilization following DBS. Overall costs associated with mental health visits and medications did not differ by time or by group. However, the percentage of patients with mental health medication use increased in the 6-month and 6 to 12 month periods post-surgery. The STN group had significantly greater increase in medication use at 6 to 12 months post-surgery compared to the GPi group (p <  0.05).
  
  
  CONCLUSIONS
  Despite a brief increase in medication use following surgery, this study suggests that mental health healthcare use and costs are stable over time and similar between DBS targets. Prior research findings of mental health-related adverse events and mood following DBS did not translate to greater mental health service utilization in our cohort. The changes seen in the year following surgery may reflect temporary adjustments with stabilization over time.
authors.affiliation: Loyola University Stritch School of Medicine, Maywood, IL, USA.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Westbay
authors.affiliation: Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA.
authors.forename: Lishan
authors.initials: L
authors.lastname: Cao
authors.affiliation: Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA.|Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Inger
authors.initials: I
authors.lastname: Burnett-Zeigler
authors.affiliation: Loyola University Stritch School of Medicine, Maywood, IL, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Reizine
authors.affiliation: Rush University Medical Center, Department of Neurological Sciences, Chicago, IL, USA.|Jesse Brown VA Medical Center, Chicago, IL, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Barton
authors.affiliation: Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA.
authors.forename: Dolores
authors.initials: D
authors.lastname: Ippolito
authors.affiliation: Loyola University Stritch School of Medicine, Maywood, IL, USA.|Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA.
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.affiliation: Loyola University Stritch School of Medicine, Maywood, IL, USA.|Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
mesh_terms: D046690:Deep Brain Stimulation / Q000009:adverse effects*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005917:Globus Pallidus / Q000503:physiopathology; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology / Q000628:therapy*; D012189:Retrospective Studies; D020531:Subthalamic Nucleus / Q000503:physiopathology; D016896:Treatment Outcome; D014728:Veterans
keywords: Deep brain stimulation; Parkinson’s disease; mental health; utilization