Diverse genetic, epigenetic, and developmental programs drive glioblastoma, an incurable and poorly understood tumor, but their precise characterization remains challenging. Here, we use an integrative approach spanning single-cell RNA-sequencing of 28 tumors, bulk genetic and expression analysis of 401 specimens from the The Cancer Genome Atlas (TCGA), functional approaches, and single-cell lineage tracing to derive a unified model of cellular states and genetic diversity in glioblastoma. We find that malignant cells in glioblastoma exist in four main cellular states that recapitulate distinct neural cell types, are influenced by the tumor microenvironment, and exhibit plasticity. The relative frequency of cells in each state varies between glioblastoma samples and is influenced by copy number amplifications of the CDK4, EGFR, and PDGFRA loci and by mutations in the NF1 locus, which each favor a defined state. Our work provides a blueprint for glioblastoma, integrating the malignant cell programs, their plasticity, and their modulation by genetic drivers.

High-grade gliomas are lethal brain cancers whose progression is robustly regulated by neuronal activity. Activity-regulated growth factor release promotes glioma growth, but this alone is insufficient to explain the effect that activity exerts on glioma progression. Here, we use singlecell transcriptomics, electron microscopy, whole-cell patch-clamp electrophysiology and calcium imaging to demonstrate that neuron-glioma interactions include electrochemical communication through bona fide AMPA receptor-dependent neuron-glioma synapses. Neuronal activity also evokes non-synaptic activity-dependent potassium currents that are amplified through gap junction-mediated tumor interconnections forming an electrically-coupled network. Glioma membrane depolarization assessed with in vivo optogenetics promotes proliferation, while pharmacologically or genetically blocking electrochemical signaling inhibits glioma xenograft growth and extends mouse survival. Emphasizing positive feedback mechanisms by which gliomas increase neuronal excitability and thus activity-regulated glioma growth, human intraoperative electrocorticography demonstrates increased cortical excitability in gliomainfiltrated brain. Together, these findings indicate that synaptic and electrical integration in neural circuits promotes glioma progression.