125 Electrophysiological effects of deep brain stimulation in anorexia nervosa months; T3-T4). After screening (T-1) we stereotactically implanted bilateral DBS electrodes model 3389, connected to an infraclavicular Activa PC neurostimulator (Medtronic, Minneapolis, USA), in the vALIC as visible on 3D reconstructed anatomical MRI-scans, 3-4 mm anterior to the anterior commissure, with a slight anterior angulation (T0). We turned on and optimized DBS settings from T1 to T2, and followed patients up to T4. During the study patients received standard medical and psychiatric care, comprising of regular visits with a nurse-practitioner and a psychiatrist. No major psychopharmacological adjustments were made. We obtained EEG recordings in patients at T1 (unstimulated but post-operative so as to remove confounding from surgery), at the end of the optimization period (T2, to investigate short term effects of stimulation), and at 12 months after ending the optimization period (T4, at the end of the maintenance phase) (See figure 1). For controls, we obtained EEG recordings once. Figure 1. The temporal phases of the DBS treatment with the timepoints of EEG at T1, T2 and T4 We closely monitored patients clinically and psychologically during the study. Primary and secondary outcomes and adverse events were published by Oudijn et al. (1). EEG recording and pre-processing Resting-state EEG recordings were obtained while patients were comfortably seated. All participants were instructed to keep their eyes open for 3 minutes and closed for a consecutive 3 minutes. For patients, resting-state EEG was obtained in two states, namely, with DBS on and DBS turned off consecutively. Only the data for DBS off are used in the current protocol. EEG was recorded using an ANT Eego system (ANT Neuro, The Netherlands) with 64 Ag/AgCl electrodes in a 10/10 montage, which included 62 EEG cannels plus two mastoid electrodes. Fpz served as ground electrode. Faulty channels (disconnected) were removed as well as highly noisy channels based on near-zero and extreme standard deviations of the detrended signals. Next, recordings were offline rereferenced against an imputed unipolar infinite reference via months; T3-T4). After screening (T-1) we stereotactically implanted bilateral DBS electrodes model 3389, connected to an infraclavicular Activa PC neurostimulator (Medtronic, Minneapolis, USA), in the vALIC as visible on 3D reconstructed anatomical MRI-scans, 3-4 mm anterior to the anterior commissure, with a slight anterior angulation (T0). We turned on and optimized DBS settings from T1 to T2, and followed patients up to T4. During the study patients received standard medical and psychiatric care, comprising of regular visits with a nurse-practitioner and a psychiatrist. No major psychopharmacological adjustments were made. We obtained EEG recordings in patients at T1 (unstimulated but post-operative so as to remove confounding from surgery), at the end of the optimization period (T2, to investigate short term effects of stimulation), and at 12 months after ending the optimization period (T4, at the end of the maintenance phase) (See figure 1). For controls, we obtained EEG recordings once. Figure 1. The temporal phases of the DBS treatment with the timepoints of EEG at T1, T2 and T4 We closely monitored patients clinically and psychologically during the study. Primary and secondary outcomes and adverse events were published by Oudijn et al. (1). EEG recording and pre-processing Resting-state EEG recordings were obtained while patients were comfortably seated. All participants were instructed to keep their eyes open for 3 minutes and closed for a consecutive 3 minutes. For patients, resting-state EEG was obtained in two states, namely, with DBS on and DBS turned off consecutively. Only the data for DBS off are used in the current protocol. EEG was recorded using an ANT Eego system (ANT Neuro, The Netherlands) with 64 Ag/AgCl electrodes in a 10/10 montage, which included 62 EEG cannels plus two mastoid electrodes. Fpz served as ground electrode. Faulty channels (disconnected) were removed as well as highly noisy channels T-1 Preopterative phase T0 Postoperative phase T1 Optimization phase (3-9 months) T2 Maintenance phase (6 months) T3 Maintenance phase (6 months) T4 End of trial EEG (T1) EEG (T2) EEG (T4) 117
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