Resting-state functional magnetic resonance imaging in glioma surgery likely reflects similar neural information as detected with intraoperative direct electrocortical stimulation (DES), but in its current form does not reach the spatial resolution of DES. 1).
A study represents a systematic review of the insights provided by resting-state functional MRI (rs-fMRI) use in the glioma population. Following PRISMA guidelines, 45 studies were included in the review and were classified in glioma-related neuronal changes (n=28) and eloquent area localization (n=17). Despite the heterogeneous nature of the studies, there is considerable evidence of diffuse functional reorganization occurring in the setting of gliomas with local and interhemispheric functional connectivity alterations involving different functional networks. The studies showed evidence of decreased long-distance functional connectivity and increased global-local efficiency occurring in the setting of gliomas. The tumor grade seems to correlate with distinct functional connectivity changes. Overall, there is a potential clinical utility of rs-fMRI for identifying the functional brain network disruptions occurring in the setting of gliomas. Further studies utilizing standardized analytical methods are required to elucidate the mechanism through which gliomas induce global changes in brain connectivity 2).