Characterization of the Blood-Brain Barrier in High-Grade Glioma Through Immunohistochemical, Transcriptional, Fluorescein and Radiological Analyses

Glioblastoma is characterized by disruption of the blood-brain barrier, which may influence tumor progression, neurological dysfunction, treatment delivery, and clinical outcomes. This study seeks to comprehensively characterize BBB integrity using multimodal approaches.

Participants with newly diagnosed GBM selected for surgical resection will undergo:

• Clinical and demographic data collection.
• Neurocognitive assessment using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Reading the Mind in the Eyes Test (RMET).
• High-resolution 3-Tesla MRI with and without gadolinium contrast, including structural and functional imaging sequences.
• Blood sampling for measurement of biomarkers associated with BBB disruption and neuronal injury, including S100β, GFAP, UCHL1, amyloid beta, phosphorylated tau, and neuron-specific enolase.
• Collection of tumor tissue during routine surgical resection for immunohistochemical and transcriptional analyses.

Serial evaluations will be performed preoperatively, postoperatively, at 72 hours, at 4 weeks, and 4 weeks following completion of radiotherapy, according to the assessment schedule.

Inclusion criteria

• Adult patients aged 18 years or older.
• Newly diagnosed glioblastoma.
• Selected for surgical tumor resection.
• Able and willing to provide written informed consent.
• Able to undergo study assessments and follow-up procedures.

Exclusion criteria

• Contraindication to magnetic resonance imaging.
• Confusion, delirium, or altered state of consciousness that interferes with the ability to provide informed consent.
• Any condition that, in the opinion of the investigator, would prevent completion of study procedures or compromise participant safety.