Neonatal Hypoxic-ischaemic Encephalopathy Classification from the EEG and HRV Signals Using a Conformer based Masked Autoencoder

This paper presents the HRVConformer, a novel deep learning architecture for the classification of hypoxic-ischemic encephalopathy (HIE) using the instantaneous heart rate (HR) signal. Unlike conventional approaches that rely on handcrafted features, HRVConformer directly processes raw HR signals in an end-to-end manner, capturing both local and long-range dependencies through a hybrid Convolution-Transformer framework. By integrating convolutional layers for local feature extraction and Transformer-based attention mechanisms for global context modelling, the architecture effectively enhances signal representation and classification performance. The model was trained using supervised learning on a large HR dataset consisting of 1,573 one-hour epochs, including 259 one-hour expert-annotated epochs and a substantial set of weakly labelled data. A 314-hour validation set provided a robust performance estimation, while an independent 215-hour dataset with expert annotations was reserved for final testing. HR signals were extracted from electrocardiogram (ECG) recordings using an improved Pan-Tompkins algorithm, which significantly enhanced both signal quality and data availability. Experimental results demonstrate that the HRVConformer achieves an AUC of 83.23% and accuracy of 74.56% on the test set. These results surpass the performance of the Transformer, ResNet50 and fully convolutional networks baselines, highlighting the advantages of integrating convolutional and Transformer-based components for HR-based HIE classification. The proposed method provides a promising step toward a more accurate and automated assessment of HIE using HR signals. The code is available at: https://github.com/syu-kylin/HRVConformer.

Learning from multi-variate time-series with heterogeneous channel configurations remains a fundamental challenge for deep neural networks, particularly in clinical domains such as intracranial electroencephalography (iEEG), where channel setups vary widely across subjects. In this work, we introduce multi-variate parallel attention (MVPA), a novel self-attention mechanism that disentangles content, temporal, and spatial attention, enabling flexible, generalizable, and efficient modeling of time-series data with varying channel counts and configurations. We use MVPA to build MVPFormer, a generative foundation model for human electrophysiology, trained to predict the evolution of iEEG signals across subjects. To support this and future efforts by the community, we release the SWEC iEEG dataset, the largest publicly available iEEG dataset to date, comprising nearly 10,000 hours of recordings from heterogeneous clinical sources. MVPFormer leverages MVPA to achieve strong generalization across subjects, demonstrating expert-level performance in several iEEG tasks. MVPFormer surpasses state-of-the-art (SOTA) Transformer baselines in seizure detection across the SWEC, the MAYO, and the FNUSA datasets, while also achieving SOTA performance on four Brain TreeBank iEEG decoding tasks (volume, pitch, onset, and speech). We further validate MVPA on standard time-series forecasting and classification tasks, where it matches or exceeds the performance of existing attention-based models. Together, our contributions establish MVPA as a general-purpose attention mechanism for heterogeneous time-series and MVPFormer as the first open-source, open-weights, and open-data iEEG foundation model with SOTA clinical performance. The code is available at https://github.com/IBM/multi-variate-parallel-transformer. The SWEC iEEG dataset is available at https://huggingface.co/datasets/NeuroTec/SWEC_iEEG_Dataset.

Masked reconstruction is widely used for EEG foundation models, but optimizing reconstruction on low-SNR waveforms does not necessarily produce the most useful latent representation. We introduce MANAS-2, a new EEG foundation model that combines a Raw-Band Hybrid (RBH) masked autoencoder with Constrained Reconstruction (ConRec), a physics-motivated regularizer. RBH jointly reconstructs temporal waveform patches and compact spectral-band targets, while ConRec acts only on the temporal decoder output, penalizing differences in RMS energy between adjacent short windows of the reconstructed waveform. ConRec is intended to shape the encoder by biasing it toward the organization of oscillatory-envelope information. Across seven held-out EEG datasets, adding ConRec to an otherwise identical RBH model increases frozen ridge recovery of six-band spectral power from mean R^2=0.860 to 0.906 and recovery of inter-patch band-energy dynamics from R^2=0.283 to 0.354, while temporal waveform information remains highly recoverable from the frozen latents. Applied to a temporal-only masked autoencoder, ConRec also improves frozen downstream transfer and frequency-dependent latent geometry despite receiving no spectral targets: i.e., the effects of ConRec are architecture-independent. MANAS-2 also outperforms leading EEG Foundation Models on most downstream knowledge-transfer tasks. From the effects of ConRec, we see that a physically motivated constraint imposed through the decoder can make for a more spectrally organized and transferable latent space. MANAS-2 therefore provides a new EEG foundation model built around constrained reconstruction as a mechanism for shaping representation--rather than reconstruction--quality.