Normative Deviation Modeling for EEG-based Depression Detection

Deep learning-based Major Depressive Disorder (MDD) detection using Electroencephalography (EEG) is fundamentally constrained by the "small-sample dilemma." Prevailing generative data augmentation methods not only incur heavy computational overhead but also risk introducing synthetic noise, thereby blurring classification boundaries. To challenge the traditional "data quantity first" convention, we propose a novel framework "Beyond Augmentation": Score-Guided Classification (SGC). SGC does not synthesize pseudo-samples; instead, it utilizes an unsupervised generative network architecture to model the structural and statistical anomaly degrees of samples, serving as the core "Pathological Prior". This prior, after robust normalization, is explicitly fused with deep feature representations, thereby precisely guiding the classifier's decision boundary. Furthermore, to dynamically adapt to varying channel configurations, we propose a Cross-Channel Spatial Adaptation module, utilizing a spatial mapping mechanism to effectively resolve the hardware heterogeneity of mismatched channels in multi-center datasets. Extensive experiments on the Mumtaz2016 and high-density MODMA datasets demonstrate the effectiveness and exceptional generalizability of our method under the challenging "zero data augmentation" setting and at "zero sample synthesis cost". Keywords: Electroencephalography (EEG), Depression Detection, Anomaly Score, Diffusion Models, Few-Shot Learning

Electroencephalography (EEG)-based closed-loop neuromodulation calls for a subject-specific structured state, as opposed to a single disease probability, specifying which brain regions are deviant, at which frequencies, and at which lags. Sensor-space models keep the strongest diagnostic evidence without anatomy, source-space models give anatomy at a loss of predictive signal, and post-hoc attributions stay outside the prediction. We separate the two instead of forcing them into one representation, and propose DMD-EEG (Dual-view Multiscale Deformation for EEG), which keeps a fixed scalp spectral expert for diagnosis and models the source-space disease-related representation as a low-rank, sparse, iterative deformation of a healthy neural-dynamics prior in a $46$-region-of-interest (ROI) $\times$ $5$-frequency $\times$ $4$-lag (autocorrelation-timescale) space. The two experts meet only at a fixed decision level, so the source state is architecturally separate from the scalp expert. Across major depressive disorder (MDD), first-episode psychosis (FEP), and Parkinson's disease (PD), decision-level fusion matches the strongest single expert on MDD and FEP and exceeds the source branch on PD. On FEP the source expert is the strongest branch, the task where the deformation contributes most. The source state is an explicit ROI-frequency-lag attribution defined in a shared source coordinate system across montages, which we treat as an anatomically-coordinated predictive representation whose coordinates are directly readable and hypothesis-generating. The highest-saliency coordinates align with established disease circuitry (fronto-limbic-temporal regions in MDD, motor-cortex beta in PD), and the MDD state transfers by rank to an unseen cohort recorded with a different montage.

Electroencephalography (EEG) is a critical tool for monitoring brain activity and diagnosing neurological disorders such as epilepsy. However, learning meaningful representations from raw EEG signals remains challenging due to limited annotations, substantial inter-subject variability, and complex temporal dynamics. Recent EEG foundation models (FMs) have demonstrated promising performance through transformer-based architectures and large-scale self-supervised pretraining, yet they often incur substantial computational costs and exhibit diminishing returns with increasing model and dataset scale, limiting their practicality in clinical settings. To address these challenges, we propose EEGDM, a diffusion-based EEG representation learning framework. Specifically, EEGDM introduces a Structured State-Space Model for Diffusion Pretraining (SSMDP) that effectively captures long-range temporal dependencies through generative diffusion training on unlabeled EEG data. The representations are subsequently leveraged for downstream tasks via our Latent Fusion Module (LFM), which integrates multi-layer latent features of SSMDP. We evaluate EEGDM on three EEG benchmarks spanning EEG event classification (TUEV), seizure detection (CHB-MIT), and seizure classification (IIIC). Compared with existing state-of-the-art methods, including EEG FMs, EEGDM achieves competitive performance across diverse tasks and datasets, exceeding existing methods in most cases while requiring substantially fewer samples for both pretraining and downstream adaptation. These results demonstrate that diffusion-based learning can unlock more discriminative EEG representations, with direct implications for epilepsy diagnosis and management. Our source code and pretrained checkpoints are publicly available at: https://github.com/jhpuah/EEGDM.