MRI reveals glioma surgery-induced brain network disruption and compensatory plasticity.

Glioma surgery, while critical for tumor control, often disrupts brain network integrity, leading to postoperative neurological deficits. This study employed resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) to assess functional and structural connectivity changes in 28 patients with supratentorial gliomas before and after surgical resection. We observed widespread reductions in functional connectivity (FC), regional homogeneity (ReHo), and amplitude of low-frequency fluctuations (ALFF) after surgery, primarily involving sensorimotor and language networks. DTI revealed significant decreases in white matter integrity (fractional anisotropy, FA) in tumor-adjacent tracts, with reduced structural connectivity between tumor-affected and contralateral regions. Notably, we identified compensatory FC enhancements in language- and cognitive-related regions, which positively correlated with postoperative Karnofsky Performance Status (KPS) scores. Inter group comparisons revealed that high-grade gliomas caused more severe network damage than low-grade tumors, and baseline network impairments were already evident preoperatively. These findings advance our understanding of glioma surgery-induced brain network disruption and highlight the role of neural plasticity in functional preservation. They also have important clinical implications for surgical planning, rehabilitation, and prognosis assessment.