Task-dependent graph-theoretical signatures of motor network reorganization as candidate presurgical markers in medial frontal IDH-wildtype glioblastoma
Year: 2026
Type: article
Abstract: Background and purpose Functional reorganization of brain networks in glioblastoma during task performance remains insufficiently understood. Although graph-theoretical analyses of resting-state connectivity have been explored in low-grade gliomas, task-based network topology in CNS WHO grade 4 glioblastoma has not been investigated. To our knowledge, this study presents the first graph-theoretical connectomic analysis of task-engaged networks in preoperative IDH-wildtype CNS WHO grade 4 glioblastoma and evaluates candidate exploratory markers of motor network reorganization. Methods Twenty-five patients with preoperative left medial frontal CNS WHO grade 4 glioblastoma and 25 healthy controls underwent task-based fMRI during a finger-tapping task. Background functional connectivity was extracted from 34 cortical, subcortical, and cerebellar regions after regression of task-related activity. Graph-theoretical metrics including degree, global efficiency, betweenness centrality, clustering coefficient, local efficiency, and average path length were calculated using the Brain Connectivity Toolbox. Group differences were assessed using covariate-adjusted general linear models with within-metric FDR correction across the 34-node panel. Results Patients demonstrated a coordinated pattern of network reorganization rather than diffuse disruption. Directionally divergent striatal alterations were observed, characterized by nominal reductions in left putamen integrity alongside a trend-level increase in left caudate connectivity, consistent with a shift toward cognitively mediated motor control. Concurrently, the right posterior parietal cortex showed reduced connectivity and global efficiency together with a broader topological pattern suggestive of bottlenecking. Recruitment of the right cerebellar hemisphere suggested redistribution of processing demands toward motor correction. In exploratory analyses, the Subcortical Composite Index (SCI) was associated with motor accuracy (ρ = 0.68, p-FDR = 0.001), whereas the Posterior Parietal Cortex Bottleneck Intensity (PPC-BI) was associated with movement variability (ρ = 0.65, p-FDR = 0.002). In an exploratory subgroup analysis, patients displaying reorganization patterns demonstrated higher motor accuracy than non-reorganizers (52.0 ± 9.1 vs. 37.0 ± 10.6 taps/block; Welch’s t-test p = 0.005). An exploratory connectomic model explained 34% of the variance in functional status (adjusted R² = 0.34, F[4, 21] = 4.06, p = 0.014). Conclusions CNS WHO grade 4 glioblastoma is associated with a coordinated pattern of network reorganization consistent with a hypothesized transition from automated to cognitively supervised motor control. The topological findings are spatially consistent with a proposed caudate–cerebellar compensatory axis, although this mechanistic account was not directly tested. Task-based graph-theoretical indices particularly SCI and PPC-BI represent exploratory, hypothesis-generating markers that, pending external validation, may eventually inform future research on presurgical risk assessment and network-informed treatment strategies. Clinical trial registration Not applicable. This study is a cross-sectional case–control neuroimaging investigation and not a clinical trial.
Source: BMC Medical Imaging
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7225810397
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