Intracranial tumors such as gliomas, meningiomas, and brain metastases induce complex alterations in brain function beyond their focal presence. Modern connectomic and neuroimaging approaches, including resting-state functional MRI (rs-fMRI) and diffusion MRI, have revealed that these tumors disrupt and reorganize large-scale brain networks in heterogeneous ways. In adult patients, diffuse gliomas infiltrate neural circuits, causing both local disconnections and widespread functional changes that often extend into structurally intact regions. Meningiomas and metastases, though typically well-circumscribed, can perturb networks via mass effect, edema, and diaschisis, sometimes provoking global “dysconnectivity” related to cognitive deficits. Therefore, this review synthesizes interdisciplinary evidence from neuroscience, oncology, and neuroimaging on how intracranial tumors disrupt functional brain connectivity pre- and post-surgery. We discuss how functional heterogeneity (i.e., differences in network involvement due to tumor type, location, and histo-molecular profile) manifests in connectomic analyses, from altered default mode and salience network activity to changes in structural–functional coupling. The clinical relevance of these network effects is examined, highlighting implications for pre-surgical planning, prognostication of neurocognitive outcomes, and post-operative recovery. Gliomas demonstrate remarkable functional plasticity, with network remodeling that may correlate with tumor genotype (e.g., IDH mutation), while meningioma-related edema and metastasis location modulate the extent of network disturbance. Finally, we explore future directions, including imaging-guided therapies and “network-aware” neurosurgical strategies that aim to preserve and restore brain connectivity. Understanding functional heterogeneity in brain tumors through a connectomic lens not only provides insights into the neuroscience of cancer but also informs more effective, personalized approaches to neuro-oncologic care.
颅内肿瘤如胶质瘤、脑膜瘤和脑转移瘤，除局部占位效应外，还会引发脑功能的复杂改变。现代连接组学与神经影像学技术（包括静息态功能磁共振成像和弥散磁共振成像）揭示，这些肿瘤以异质性方式破坏并重组大规模脑网络。在成人患者中，弥漫性胶质瘤浸润神经环路，既造成局部连接中断，又引发广泛的功能改变，这些改变常延伸至结构完整的脑区。脑膜瘤和转移瘤虽通常边界清晰，但可通过占位效应、水肿及远隔效应干扰神经网络，有时甚至引发与认知缺陷相关的全局性"连接失调"。因此，本综述整合了神经科学、肿瘤学和神经影像学等多学科证据，系统阐述颅内肿瘤如何影响术前术后脑功能连接。我们探讨了功能异质性（即因肿瘤类型、位置和组织分子特征差异导致的网络参与度不同）在连接组学分析中的表现，包括默认模式网络与凸显网络活动改变，以及结构-功能耦合变化。本文进一步审视这些网络效应的临床意义，重点探讨其对术前规划、神经认知预后评估及术后恢复的影响。胶质瘤展现出显著的功能可塑性，其网络重塑可能与肿瘤基因型（如IDH突变）相关，而脑膜瘤相关水肿和转移瘤位置则调节着网络紊乱的程度。最后，我们展望未来发展方向，包括影像引导治疗和旨在保护与恢复脑连接的"网络感知"神经外科策略。通过连接组学视角理解脑肿瘤的功能异质性，不仅为癌症神经科学提供新见解，更有助于制定更有效、个性化的神经肿瘤诊疗方案。
肿瘤(癌症)患者之家