In the present study, we showed altered ipsilesional connectivity in patients with unilateral gliomas. TFNBS analysis identified significant disconnected subnetworks involving fronto-frontal and fronto-insular connections in the ipsilesional hemisphere compared to the contralateral one. Our subgroup analysis also showed that the lesion location (e.g., pre-central and insular) affected connectivity patterns that belong to distinct and peculiar subnetworks, thus highlighting the pivotal role of lesion location in driving corresponding connectivity changes. Such connectivity changes were accompanied by reduced global and local efficiency of the ipsilesional network, suggesting tumor-related altered information transfer, which is due to the pathological involvement of both long- and short-range connectivity patterns and disturbed network integration. Moreover, we observed a correlation between the difference of the matrices in terms of hierarchy as well as local efficiency and functional impairment scales, such as MRC and NIHSS. Additionally, deterministic and probabilistic connectome matrices correlated strongly positively in local and global efficiency in ipsi- and contralesional groups. The integration of connectomics into clinical applications is of paramount importance and provides a novel perspective in the neurooncological scenario having the potential to revolutionize personalized medicine and therapy. Indeed, studying structural connectivity in glioma patients through the lens of network neuroscience may guide and improve tumor resection while preserving important nodes and edges which are located more distant from the lesion but also involved in motor and cognitive functions. Finally, network neuroscience represents an important computational approach to better understand glioma-induced structural changes and contributes to our understanding on the relationship of network topology to motor function.
To further characterize the glioma impact on the structural networks, we made use of graph-based complex network analyses on the same matrices that were used as input for TFNBS5. We used measures of network efficiency to detect aspects of functional integration and segregation5. We assessed the global efficiency92, a measure of network integration. Global efficiency allows to assess disconnected networks, as paths between disconnected nodes are defined to have infinite length, and correspondingly zero efficiency. Additionally, we measured the local efficiency92, a measure of network segregation. Local efficiency reflects the extent of integration between the immediate neighbors of the given node93,94. Furthermore, we computed measures of assortativity, degree, centrality, hierarchy, nodal efficiency, and rich club and small world organization to analyze the vulnerability and resilience of the networks and detect possible abnormalities of network connectivity5. These graph theoretical network analyses were performed by GRETNA 2.0.095. 59ce067264