Connectomics-based functional networks in temporal gliomas

Patients with temporal gliomas often experience severe cognitive impairment after surgery, despite the attention given to the protection of cognitive structures during surgery. Connectomics provides a unified, network-based view dedicated to mapping and understanding the structural and functional topology of the human brain. This study aims to elucidate the characteristics of temporal glioma invasion into brain networks (including the salience network, central executive network, default mode network, dorsal attention network, and ventral attention network) and summarize the clinical effectiveness and practical experience in protecting cognitive function under the guidance of connectomics. First, connectomics was utilized to construct personalized brain functional networks for each patient, enabling a retrospective analysis of the invasion characteristics of 53 temporal gliomas for both functional structures and brain networks. The therapeutic effects of connectomics-optimized surgical programs (the experimental group) and traditional surgical strategies (the control group) on patients’ brain structures and cognitive functions were subsequently compared in 29 patients with temporal gliomas and 18 patients with left temporal gliomas. In 52/53 patients (98.11%), tumour infiltration into brain networks and fasciculus was observed at a higher rate than tumour infiltration into functional structures (94.34%). Despite the lack of significant differences in the preoperative characteristics of tumour invasion, under the guidance of connectomics, the protection rates of brain networks and functional structures in 16 postoperative glioma patients were noticeably higher than those in 13 glioma patients who underwent traditional surgeries ( P = 0.000 and P = 0.029, respectively). When analysing left temporal gliomas, the protection rates of brain networks and functional structures in the 8 postoperative patients in the experimental group were also significantly greater than those in the 10 patients in the control group ( P = 0.017 and P = 0.029, respectively). Both surgical outcomes and cognitive scores achieved with connectomics-guided programs significantly were better than those achieved with traditional treatment protocols ( P < 0.05). During the surgical treatment of temporal gliomas, it is essential to not only preserve traditional functional structures but also to retain brain networks with advanced cognitive functions. Preliminary evidence indicates that connectomics-based visualization of functional networks improves neurosurgical comprehension, optimizes surgical programs, and holds the potential to minimize surgical trauma while enabling superior levels of tumour resection with preserved functional outcomes.