Exploration and Characterization Ofintratumoral Electrophysiological Heterogeneity in Gliomas Using Magnetoencephalography

Exploration and Characterization Ofintratumoral Electrophysiological Heterogeneity in Gliomas Using Magnetoencephalography

With more than 3,000 new cases per year in France, malignant gliomas are the most common malignant brain tumors in adults.

Treatment consists of surgical removal when possible. If this is not possible, a biopsy is performed to obtain a definitive anatomical and molecular diagnosis. Standard medical management after removal or biopsy is based on radio-chemotherapy. Despite this multimodal treatment, progression is the norm due to the invasive nature of these tumors. The prognosis remains very poor, with a median overall survival of around 18 months for glioblastomas.

Recent preliminary data indicate that magnetoencephalography (MEG) recordings can identify functional heterogeneity within a glioma. Functional analysis of these two types of areas has shown that the expression of synaptogenic factors is increased in areas of high functional connectivity compared to areas of low functional connectivity. Areas of high functional connectivity are more aggressive and more resistant to treatment.

In general, gliomas are characterized by a high degree of inter- and intra-tumoral heterogeneity. The latter has been well characterized at the transcriptomic level, and several distinct cell subpopulations have been described (classical, mesenchymal, proneural) This intra-tumoral heterogeneity is one of the factors contributing to resistance to current therapies, but it remains incompletely understood and explored. MEG is a tool capable of exploring intra- and inter-tumor heterogeneity from an electrophysiological perspective. This represents an original approach that will provide a better understanding of intra-tumor heterogeneity and lead to new therapeutic perspectives.

Inclusion Criteria:

• Male or female aged over 18
• With a newly diagnosed malignant glioma based on brain imaging
• Eligible for surgical removal
• Having given their consent

Exclusion Criteria:

• Contraindications to Magnetic resonance imaging (MRI) (claustrophobia, metallic implants, particularly intraocular implants, pacemakers)
• Contraindications to magnetoencephalography (MEG) (metallic implants in the mouth-dentures, fillings, crowns)
• Coagulation disorders
• Pregnancy, breastfeeding, or patients not using effective contraception
• Subjects participating in another interventional study with an exclusion period still in progress at the time of pre-inclusion, etc.
• Subjects deprived of their liberty by judicial or administrative decision
• Subjects receiving psychiatric care
• Subjects admitted to a health or social care facility for purposes other than research
• Adult subjects subject to legal protection measures (guardianship, curatorship)
• Subjects not affiliated with a social security system or beneficiaries of a similar system