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胶质母细胞瘤与脑连接:范式转变的需要。

Glioblastoma and brain connectivity: the need for a paradigm shift.

机构信息

Clinica Neurologica, Azienda Ospedale Università Padova, Padova, Italy; Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy.

Department of Neuroscience, University of Padova, Padova, Italy.

出版信息

Lancet Neurol. 2024 Jul;23(7):740-748. doi: 10.1016/S1474-4422(24)00160-1.


DOI:10.1016/S1474-4422(24)00160-1
PMID:38876751
Abstract

Despite substantial advances in cancer treatment, for patients with glioblastoma prognosis remains bleak. The emerging field of cancer neuroscience reveals intricate functional interplays between glioblastoma and the cellular architecture of the brain, encompassing neurons, glia, and vessels. New findings underscore the role of structural and functional connections within hierarchical networks, known as the connectome. These connections contribute to the location, spread, and recurrence of a glioblastoma, and a patient's overall survival, revealing a complex interplay between the tumour and the CNS. This mounting evidence prompts a paradigm shift, challenging the perception of glioblastomas as mere foreign bodies within the brain. Instead, these tumours are intricately woven into the structural and functional fabric of the brain. This radical change in thinking holds profound implications for the understanding and treatment of glioblastomas, which could unveil new prognostic factors and surgical strategies and optimise radiotherapy. Additionally, a connectivity approach suggests that non-invasive brain stimulation could disrupt pathological neuron-glioma interactions within specific networks.

摘要

尽管癌症治疗取得了重大进展,但胶质母细胞瘤患者的预后仍然不容乐观。癌症神经科学这一新兴领域揭示了胶质母细胞瘤与大脑细胞结构之间错综复杂的功能相互作用,包括神经元、神经胶质细胞和血管。新的发现强调了在称为连接组的层次网络内结构和功能连接的作用。这些连接有助于胶质母细胞瘤的位置、扩散和复发,以及患者的整体存活率,揭示了肿瘤与中枢神经系统之间的复杂相互作用。这一不断增加的证据促使范式转变,挑战了将胶质母细胞瘤仅仅视为大脑内异物的观念。相反,这些肿瘤与大脑的结构和功能组织紧密交织在一起。这种思维方式的根本性转变对理解和治疗胶质母细胞瘤具有深远的意义,可能揭示新的预后因素和手术策略,并优化放疗。此外,连接性方法表明,非侵入性脑刺激可能会破坏特定网络中病理性神经元-胶质细胞瘤的相互作用。

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