107 Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study weighed against the pre-DBS time point (T-1) to improve statistical power. A region of interest (ROI) analysis was performed for the ventral striatum (VS) and the medial orbitofrontal cortex (mOFC). These regions were chosen a-priori based on their strong relation to reward processing (13), their role in AN pathology and their previous use in AN-fMRI-studies (14-16). Furthermore, the VS was also the target of DBS. The VS was based on peak-coordinates from a previous study using a similar monetary reward task (17). The mOFC was based on the IBASPM 71 atlas in the WFU Pickatlas toolbox in SPM12. Voxel-wise statistical tests were family-wise error (FWE) rate corrected for multiple comparisons (p<0.05) across the whole-brain at the cluster level using a height-threshold of p<0.001 or for ROIs at the voxel level using a small volume correction (SVC) (35). RESULTS Sample characteristics Four patients with treatment-refractory AN were included in this study and underwent DBS of the vALIC, during 12 months follow-up. Mean age was 39 (SD=10) and illness duration 21 years (SD=3). All patients were female and suffered from binge-purging subtype of AN. Average BMI at baseline was 12.5 (SD=1.0) kg/m², indicating extremely severe AN. All patients suffered from psychiatric comorbidities. Two patients were diagnosed with personality disorder not otherwise specified (PD-NOS), one patient was diagnosed with major depressive disorder (MDD) and one patient was diagnosed with both PD-NOS and MDD. All demographic characteristics are shown in table 1. Table 1. Patient’s demographics. Sex Age at onset (years) Age at surgery (years) Illness duration (years) Anorexia Subtype BMI (screening) BMI (Historic low) Psychiatric comorbidities Psychiatric medication at surgery Patient 1 f 15 32 18 Purging 12.4 9.5 GAD, Depression, Personality Disorder NOS Aripiprazole, Quetiapine, Oxazepam Patient 2 f 15 39 24 Purging 11.2 10.2 SUD*, Personality Disorder NOS Aripiprazole, Quetiapine, Oxazepam Patient 3 f 14 33 19 Purging** 13.4 10.6 Depression, OCD, BPD Venlafaxine, Clorazepate, Oxazepam, Temazepam Patient 4 f 27 53 24 Purging 13.1 9.7 Personality Disorder NOS Citalopram, Alprazolam, Zolpidem Mean (SD) 18 (6) 39 (10) 21 (3) 12.5 (1.0) 10.0 (0.5) (BMI= Body Mass Index, f= female, GAD= Generalized Anxiety Disorder, OCD=Obsessive Compulsive Disorder, NOS= Not Otherwise Specified, SUD= Substance use disorder and BPD=Borderline Personality disorder) *The substance in question was alcohol, at screening this was in remission. ** Important to note that for purging this patient used ± 50 Bisacodyl.
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