Mapping social cognition in patients with gliomas: Preoperative and intraoperative insights from fMRI, MEG, and direct electrical stimulation

Social cognition refers to a range of processes that allow us to make sense of others' behaviors and engage in daily interactions. A key network supporting social cognition is the mirror neuron system (MNS), a set of fronto-parietal regions that allows inferring others' intentions through action observation. The MNS exhibits considerable plasticity based on an individual's motor repertoire, but little is known about its potential for reorganization in the presence of brain damage. To address this gap, we investigated the adaptive capacity of the MNS in patients with gliomas affecting key network hubs (e.g., IFG), alongside healthy controls. We evaluated social cognition preoperatively through an action comprehension task combined with MEG and fMRI recordings; and intraoperatively using this task paired with direct electrical stimulation. The preoperative functional mapping revealed that healthy controls engaged bilateral fronto-parietal areas, with a stronger involvement of the left IFG. At the oscillatory level, MEG findings mirrored this pattern and revealed early power increases in sensorimotor mu rhythms (8−14 Hz), particularly within the left hemisphere. Patients with right frontal gliomas exhibited patterns similar to controls, while those with left frontal gliomas showed a shift towards right homologue regions. Intraoperative mapping identified positive sites in the IFG and, subcortically, in the second branch of the superior longitudinal fasciculus (SLF-II). Overall, these findings underscore the crucial role of frontal connectivity in social inference and the MNS potential for reshaping in response to brain damage, offering insights into the neural mechanisms underlying social cognition in health and disease.