Increased functional connectivity in glioma: separating compensation from tumor-promoting remodeling

Increased functional connectivity (FC) in glioma is often interpreted as compensatory neuroplasticity or tumor-promoting circuit remodeling, although FC is a measure of coupling rather than a mechanism. We propose a qualitative framework that first examines whether the measurement is suitable for the claim, then evaluates evidence for patient function and tumor behavior separately. The two lines of evidence are combined only when they concern the same patient context, anatomical compartment, metric, and time course. The framework also distinguishes maladaptive or excitability-related remodeling from tumor promotion. Human longitudinal studies associate network restoration with recovery, whereas experimental cancer neuroscience shows that neural activity and neuron-glioma synapses can promote malignant behavior. Increased FC should therefore be reported with its modality, metric, comparator, compartment, disease phase, reliability, and prespecified outcomes before being interpreted as compensatory, maladaptive, or tumor-promoting.