Fig. 3.

Impact of DBS electrode implantation in the STN on motor networks of 13 patients suffering from PD in the absence of medication and with DBS switched off. (a) UPDRS-III scores indicating alleviation of PD motor symptoms in the acute phase of microlesion followed by a relapse to the pre-operative levels in the latter stages after implantation. In addition, effect of STN DBS is shown in gray bars 1 month and 1 year after implantation. The bars show mean, first/third quartile, and lower/upper adjacent values. (b) Outlined search space (region-of-interest) used for EC calculations and subsequent statistics comprising the entire motor system of the brain overlaid on a standardized stereotactic brain. (c) Reorganization of central motor communication hubs due to microlesion effect following the DBS electrode penetration in the STN. The brainstem was identified as the central functional connectivity hub sensitive to microlesion. Summary of obtained statistics is shown in Table 2. 0–3 d — days 0–3; 1 m — 1 month; 1 year — 1 year; DBS — deep-brain stimulation; EC — eigenvector centrality; FDR — false discovery rate; L — left; LBs — lower brainstem; MLE — microlesion effect; PD — Parkinson's disease; Post — post-implantation stage(s); Pre — pre-implantation stage; R — right; STN — subthalamic nucleus; UBs — upper brainstem; and UPDRS-III — motor part of the Unified Parkinson's Disease Rating Scale; ** — p < 0.01; *** — p < 0.001.