BREIT: A Framework for Brain Stroke Reconstruction using Multi-Frequency 3D EIT

Motor imagery (MI) electroencephalography (EEG) decoding could support post-stroke rehabilitation, but models developed on healthy cohorts may not transfer reliably to pathological EEG. We evaluated whether Low-Rank Adaptation (LoRA) can efficiently adapt three pretrained EEG foundation models (i.e., LaBraM-base, REVE-base, and REVE-large) for binary left- versus right-hand MI decoding. Frozen-backbone head-only baselines and LoRA adaptation were evaluated using subject-wise five-fold cross-validation on the PhysioNet EEG Motor Movement/Imagery Dataset and a binary subset of the UET175 dataset comprising 30 stroke participants. On EEGMMIDB, LoRA increased accuracy to 0.822 for LaBraM-base and 0.957 for REVE-base. On UET175, all head-only models performed near chance. With LoRA, LaBraM-base remained near chance (0.499$\pm$0.009), whereas REVE-base reached 0.847$\pm$0.194 and outperformed REVE-large (0.806$\pm$0.178), indicating that increased model capacity alone did not improve stroke-domain adaptation. The strongest stroke configuration, REVE-base LoRA, was further evaluated using within-cohort leave-one-subject-out cross-validation (LOOCV), showing 0.952 mean accuracy, but subject-wise accuracy ranged from 0.586 to 1.000, revealing a small low-performing tail. Zero-shot transfer from EEGMMIDB to UET175 remained near chance (0.464$\pm$0.072). These findings show that healthy-benchmark performance does not ensure transfer to stroke EEG. Translation of EEG foundation models to pseudo-online or real-time rehabilitation BCIs should therefore include target-domain adaptation and subject-level assessment of temporal informativeness, spatial sensitivity, and physiological discriminability.

Stroke patient cross-subject electroencephalography (EEG) decoding of motor imagery (MI) brain-computer interface (BCI) is essential for motor rehabilitation, yet lesion-related abnormal temporal dynamics and pronounced inter-patient heterogeneity often undermine generalization. Existing adaptation methods are easily misled by pathological slow-wave activity and unstable target-domain pseudo-labels. To address this challenge, we propose PA-TCNet, a pathology-aware temporal calibration framework with physiology-guided target refinement for stroke motor imagery decoding. PA-TCNet integrates two coordinated components. The Pathology-aware Rhythmic State Mamba (PRSM) module decomposes EEG spatiotemporal features into slowly varying rhythmic context and fast transient perturbations, injecting the fused pathological context into selective state propagation to more effectively capture abnormal temporal dynamics. The Physiology-Guided Target Calibration (PGTC) module constructs source-domain sensorimotor region-of-interest templates, imposing physiological consistency constraints and dynamically refining target-domain pseudo-labels, thereby improving adaptation reliability. Leave-one-subject-out experiments on two independent stroke EEG datasets, XW-Stroke and 2019-Stroke, yielded mean accuracies of 66.56% and 72.75%, respectively, outperforming state-of-the-art baselines. These results indicate that jointly modeling pathological temporal dynamics and physiology-constrained pseudo-supervision can provide more robust cross-subject initialization for personalized post-stroke MI-BCI rehabilitation. The implemented code is available at https://github.com/wxk1224/PA-TCNet.

Motor imagery electroencephalography (MI-EEG) decoding offers a non-invasive route for post-stroke rehabilitation, but cross-patient use remains difficult because pathological neural reorganization changes task-related EEG dynamics, aperiodic activity, local excitability, cross-regional coordination, and trial-level brain-state context. This makes source-learned MI representations unreliable for unseen patients. To address this problem, we propose CFSPMNet, a cross-patient adaptation framework that models post-stroke MI-EEG as latent neural-state organization. CFSPMNet combines a Fourier-Reorganized State Mamba Network (FRSM) with Shared-Private Prototype Matching (SPPM). FRSM represents each trial as a latent physiological token sequence, reorganizes token states in the Fourier domain, and uses Fourier-derived trial context to guide Mamba state-space propagation. SPPM improves target pseudo-label updating by combining semantic confidence with shared-private physiological consistency, filtering confident but physiologically inconsistent target predictions. Leave-one-subject-out experiments on two stroke MI-EEG datasets show that CFSPMNet outperforms representative CNN-, Transformer-, Mamba-, and adaptation-based baselines, achieving average accuracies of 68.23% on XW-Stroke and 73.33% on 2019-Stroke, with gains of 5.63 and 8.25 percentage points over the strongest competitors. Ablation, sensitivity, feature-alignment, pseudo-label selection, and neurophysiological visualization analyses further support the roles of Fourier-domain token-state reorganization and calibrated pseudo-label updating. These results suggest that latent neural-state modeling can improve rehabilitation-oriented cross-patient BCI decoding. Code is available at https://github.com/wxk1224/CFSPMNet.