Brain Connectivity Changes in Glioma Patients During Treatment

Functional Reorganization and Connectivity in Glioma Patients During the Therapeutic Trajectory

The goal of this observational study is to better understand how the brain changes during the treatment of glioma. In particular, the study looks at changes in important brain areas that are responsible for functions such as movement, language, or sensation, as well as the nerve fiber pathways that connect these areas.

The main question this study aims to answer is:

How do important brain areas and their connections adapt and reorganize over the course of glioma treatment?

Patients with glioma will undergo repeated brain imaging examinations as part of their regular medical care. These images will be analyzed over time to observe changes in brain activity and structure during different stages of therapy.

By studying these changes, researchers hope to gain new insights into the brain's ability to adapt (neuroplasticity) throughout the entire course of glioma treatment.

Inclusion Criteria:

• Patients with diffuse gliomas (WHO grade 2-4).
• Age >18 years and <65 years.
• Written participant information and informed consent provided and signed.
• Signed informed consent for functional magnetic resonance imaging (fMRI).

Exclusion Criteria:

• Age <18 years or >65 years.

• Pregnancy.

• Contraindications to MRI, including but not limited to:

  • Active medical implants (e.g., pain pump, defibrillator, cardiac pacemaker),
  • Orthodontic braces,
  • Metallic tattoos,
  • Non-removable piercings,
  • Known metallic foreign bodies,
  • Claustrophobia.

• Cerebral metastases from secondary (non-primary) tumors.

• Absence of baseline BOLD functional MRI and/or baseline neurocognitive assessment.

• Failure to provide written participant information and informed consent.

• Karnofsky Performance Status (KPS) <60, unless feasibility of clinical-psychological testing and BOLD fMRI is confirmed by the investigator in consultation with clinical psychology, radiology staff, and the patient.