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| Hauptseite > Publikationsdatenbank > Strukturelle und funktionelle Konnektivität in Tumorpatienten |
| Dissertation / PhD Thesis | FZJ-2026-02254 |
2025
Abstract: The functional organization of the human brain is based on neuronal connections (edges) between cortical regions (nodes), known as structural connectivity. This may become disrupted by tumor growth or multimodal treatments, leading to cognitive impairment. Functional connectivity, on the other hand, is defined as the temporally correlated activity of nodes, established by some or all of the anatomical edges between them. We hypothesize that tumor- and therapy-induced lesions differentially affect white matter integrity, resulting in reduced structural connectivity and impaired cognitive performance. Furthermore, the degree of functional connectivity between tumor-infiltrated brain regions and affected brain networks should be associated with overall survival. In a cohort of 121 patients with recurrent glioma, the integrity of the white matter in various cortical lesions was initially assessed. For this purpose, the local neuronal fiber density was determined using state-of-the-art tractography methods. The underlying tractographies were then used together with the results of a cognitive performance test battery to establish a relationship between cognition and brain connectivity using a machine learning approach. To investigate resting-state functional connectivity between metabolically active glioma regions and brain networks, a correlation analysis was performed in a subset of 82 patients. The significantly impaired integrity of the white matter due to edema and gliosis had a similar negative impact on the performance status of the patients as that of the contrast- enhancing tumor parts. Reduced structural connectivity between resting-state networks was identified as a critical factor in cognitive performance, with the majority of affected nodes located in the left hemisphere. Additionally, resting-state functional connectivity to these networks was preserved in the metabolically active glioma region, with connectivity to specific networks associated with improved overall survival. In order to maintain the overall performance of glioma patients and reduce cognitive decline, treatment planning should adopt a more network-based approach, taking into account the influence of edema and gliosis. Additionally, a great clinical potential for prognostication lies in the functional connectivity between the glioma region and the surrounding brain tissue.
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