Martínez Lozada Pablo S, Pozo Neira Johanna, Leon-Rojas Jose E
NeurALL Research Group, Quito 170157, Ecuador.
PsyBRAIN Research Group, Instituto de Neurociencias, Universidad Católica de Cuenca, Cuenca 10105, Ecuador.
Cancers (Basel). 2025 Jun 27;17(13):2174. doi: 10.3390/cancers17132174.
Intracranial tumors such as gliomas, meningiomas, and brain metastases induce complex alterations in brain function beyond their focal presence. Modern connectomic and neuroimaging approaches, including resting-state functional MRI (rs-fMRI) and diffusion MRI, have revealed that these tumors disrupt and reorganize large-scale brain networks in heterogeneous ways. In adult patients, diffuse gliomas infiltrate neural circuits, causing both local disconnections and widespread functional changes that often extend into structurally intact regions. Meningiomas and metastases, though typically well-circumscribed, can perturb networks via mass effect, edema, and diaschisis, sometimes provoking global "dysconnectivity" related to cognitive deficits. Therefore, this review synthesizes interdisciplinary evidence from neuroscience, oncology, and neuroimaging on how intracranial tumors disrupt functional brain connectivity pre- and post-surgery. We discuss how functional heterogeneity (i.e., differences in network involvement due to tumor type, location, and histo-molecular profile) manifests in connectomic analyses, from altered default mode and salience network activity to changes in structural-functional coupling. The clinical relevance of these network effects is examined, highlighting implications for pre-surgical planning, prognostication of neurocognitive outcomes, and post-operative recovery. Gliomas demonstrate remarkable functional plasticity, with network remodeling that may correlate with tumor genotype (e.g., IDH mutation), while meningioma-related edema and metastasis location modulate the extent of network disturbance. Finally, we explore future directions, including imaging-guided therapies and "network-aware" neurosurgical strategies that aim to preserve and restore brain connectivity. Understanding functional heterogeneity in brain tumors through a connectomic lens not only provides insights into the neuroscience of cancer but also informs more effective, personalized approaches to neuro-oncologic care.
胶质瘤、脑膜瘤和脑转移瘤等颅内肿瘤除了其局部存在外,还会引起脑功能的复杂改变。包括静息态功能磁共振成像(rs-fMRI)和扩散磁共振成像在内的现代连接组学和神经影像学方法已经揭示,这些肿瘤以异质性方式破坏和重组大规模脑网络。在成年患者中,弥漫性胶质瘤浸润神经回路,导致局部连接中断和广泛的功能变化,这些变化通常会延伸到结构完整的区域。脑膜瘤和转移瘤虽然通常边界清晰,但可通过占位效应、水肿和远隔性脑软化扰乱网络,有时会引发与认知缺陷相关的全身性“连接障碍”。因此,本综述综合了神经科学、肿瘤学和神经影像学等多学科证据,阐述颅内肿瘤如何在手术前后破坏脑功能连接。我们讨论了功能异质性(即由于肿瘤类型、位置和组织分子特征导致的网络受累差异)在连接组学分析中的表现,从默认模式和突显网络活动的改变到结构-功能耦合的变化。研究了这些网络效应的临床相关性,强调了其对术前规划、神经认知结果预后和术后恢复的影响。胶质瘤表现出显著的功能可塑性,其网络重塑可能与肿瘤基因型(如异柠檬酸脱氢酶突变)相关,而脑膜瘤相关水肿和转移瘤位置则调节网络干扰的程度。最后,我们探讨了未来的方向,包括影像引导治疗和旨在保留和恢复脑连接的“网络感知”神经外科策略。通过连接组学视角理解脑肿瘤中的功能异质性,不仅能深入了解癌症神经科学,还能为更有效、个性化的神经肿瘤护理方法提供依据。
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