Neuroimaging

Multi-site functional MRI (fMRI) studies are essential for robust neuropsychiatric diagnosis yet suffer severe domain shifts from scanner heterogeneity, demographics, and site-specific acquisition protocols. Traditional domain adaptation requires concurrent source and target data access, violating clinical privacy regulations. Moreover, functional connectivity matrices lie on the Symmetric Positive Definite (SPD) manifold, where Euclidean operations cause geometric distortions corrupting diagnostic patterns. We propose BrainRiem, a source-free domain adaptation framework learning compact Riemannian brain prototypes via manifold-aware bi-level optimization. It employs the Log-Euclidean Metric to ensure prototypes remain valid SPD matrices, while Dirichlet Energy spectral calibration aligns their frequency characteristics with real brain networks. Only anonymized prototypes are transmitted to target sites, serving as stable anchors for training local models without source data access and reducing leakage under the evaluated attacks. Comprehensive experiments on ABIDE and REST-meta-MDD show BrainRiem consistently outperforms state-of-the-art source-free, traditional, and graph domain adaptation methods across diverse scanners and demographics. Notably, learned prototypes exhibit biologically interpretable connectivity patterns aligning with established neuroscience findings, validating the necessity of Riemannian geometry for brain network analysis.

A growing number of techniques leverage the spatial structures that underlie many real-world datasets. Despite these advances, the complementary task of estimating spatial structures and understanding their role within these techniques has often been overlooked. In neurophysiological data analysis specifically, numerous methods exist to estimate brain connectivity, but most are not explicitly model-based, dynamic, multivariate, or directed. To address these limitations, we previously introduced noise-driven heat modelling on graphs for neurophysiological connectivity estimation. In this study, we extend this framework by relaxing earlier noise assumptions and adding regularisation to improve robustness. We also develop a simulation procedure to characterise and evaluate our technique in a controlled setting. Finally, we demonstrate that the technique is able to capture meaningful spatial structure across two experiments, each using two real-world datasets. The explicit model formulation of our connectivity estimator has the potential to improve the interpretability of graph-based techniques across a wide range of applications. The code implementing our method is available at https://github.com/sgoerttler/Heat_Connectivity.

Multi-Frequency Electrical Impedance Tomography (MF-EIT) is a non-invasive, low-cost modality that reconstructs electrical property distributions from boundary voltages. For stroke imaging, progress in 3D deep-learning reconstruction is limited by the lack of large-scale datasets with paired ground-truth (GT) volumes and by non-standardized pipelines for data generation, simulation, and evaluation. We introduce BREIT, a modular framework for 3D MF-EIT stroke reconstruction providing: (i) a neuroimaging-to-EIT pipeline that converts CT/MRI into frequency-dependent GT admittivity volumes; (ii) a self-contained Python 3D Complete Electrode Model (CEM) forward solver for simulating MF-EIT voltages; and (iii) a 3D D-bar implementation supporting non-uniform electrode layouts. Building on BREIT, we propose dFNO-bar, which integrates Fourier Neural Operators into D-bar by learning a mapping from scattering data $t(ξ)$ to conductivity $σ(x){=}\Re\{γ\}$. We evaluate dFNO-bar against D-bar, Deep D-bar, and Gauss--Newton reconstructions on UCLH-matched synthetic data, and observe higher brain SSIM with comparable CC across noise settings.

Causally linking disease-related factors to image-derived biomarkers provides a powerful pathway to understanding disease mechanisms. Despite growing interest in applying causal artificial intelligence (AI) approaches for this task, these methods still need to be adapted for complex medical images, and especially, neuroimaging. However, the lack of ground-truth data presents a barrier to development. To bridge this gap, we developed and tested a method for generating synthetic neuroimages, which adhere to a user-specified causal structure describing the non-image to image variable relationships, permitting the creation of ground-truth neuroimaging datasets. In the simulated T1-weighted magnetic resonance images, anatomical variability is modeled by sampling from a subspace estimated from real data and deforming a template image to create unique simulated subjects. Causal relationships are encoded via precise volumetric changes of any region-of-interest without unwanted global artifacts. We achieved relative volume errors of 0.3-2.66% for the targeted regions-of-interest and demonstrate their statistically significant causal relationships, while maintaining mean absolute errors for non-target brain regions between 0.034-0.397ml. An initial evaluation of causal discovery methods exposes their limited ability to suppress spurious connections, highlighting the need for image-appropriate methods. Our framework is the first to enable the generation of realistic synthetic 3D neuroimages with explicit causal control that can serve as the missing ground-truth data necessary for the objective benchmarking and development of causal AI methods.

Forecasting longitudinal brain lesion evolution is critical for disease monitoring and treatment planning. Existing approaches typically learn a direct mapping from a baseline image to a future observation, without explicitly modeling the physical mechanisms underlying the lesion progression. Such an entangled modeling of structural deformation and image intensity variation limits physical plausibility, model generalization, and interpretability. To address this, we propose PDF, a Physics-grounded Disentangled Flow matching framework for longitudinal brain disease forecasting. We explicitly decompose the longitudinal modeling of lesion growth into two processes, each learned by a dedicated flow matching network: morphology evolution, which captures lesion growth and structural deformation; and intensity evolution, which models signal changes driven by variations in lesion concentration. To enforce physics-grounded constraints, we introduce a PDE-regularized loss based on lesion growth dynamics, that enforces a diffusion-reaction-advection formulation for morphological evolution. Experiments on three public longitudinal datasets spanning diverse brain diseases demonstrate state-of-the-art performance, validating the effectiveness of the disentangled modeling framework and physics-grounded learning design. Code is publicly available at https://github.com/jhuldr/PDF.

Introduction: Objective neuroimaging biomarkers may improve Parkinson's disease motor assessment by capturing brain variation not directly observable from clinical examination. We used interpretable machine learning to predict current motor severity, measured by MDS-UPDRS Part III, from QSM and multiband multi-echo resting-state fMRI-derived ReHo features. Methods: Regional QSM and ReHo features were extracted from 28 participants, including 24 individuals with Parkinson's disease and 4 controls. Thirteen feature-set experiments evaluated imaging-only, clinical-only, imaging-plus-clinical, full, reduced, and multimodal inputs. Support vector regression, Elastic Net, Random Forest, and XGBoost models were trained using nested cross-validation. Performance was assessed using pooled held-out R^2, RMSE, MAE, Pearson correlation, permutation testing, and the proportion of participants predicted within +/-5 MDS-UPDRS Part III points. Results: Imaging-only models carried meaningful predictive signal, whereas the clinical-only model performed weakly. Full fMRI, full QSM, and clinical variables provided the strongest global fit, explaining 45.4% of variance in motor severity. Selected QSM plus clinical variables produced the most clinically close predictions, with 75.0% of participants predicted within +/-5 points and the lowest MAE among top-performing models. SHAP highlighted cerebellar, thalamic, striatal, insular, and motor cortical features. Conclusion: QSM and multiband multi-echo fMRI-derived ReHo capture distinct, interpretable dimensions of Parkinson's disease motor severity. These findings show that structural and functional imaging contribute differently depending on the clinical prediction goal.

Diffusion MRI (dMRI) tractography enables non-invasive reconstruction of white-matter pathways, but its accuracy is fundamentally limited by indirect, low-resolution measurements of axonal organization. Tracer injection studies in non-human primates provide a gold standard for validating dMRI tractography. This, however, requires time-consuming manual annotation of fiber bundles in histology sections. We propose a synthetic-data augmented framework for automated fiber bundle segmentation in macaque tracer histology. Our approach uses ex vivo dMRI tractography as a generative prior to synthesize 2D image patches for training. This provides us with sufficiently realistic foreground texture, which we compose with backgrounds from blockface photos and diversify via domain randomization. A 2D U-Net is trained on mixed real and synthetic patches. Experiments on held-out brains demonstrate improved generalization across brains and fiber bundle densities compared to training with real data only. Training with synthetic data only leads to poor performance, underscoring the need for real supervision. Overall, our approach achieves performance comparable to the state-of-the-art while requiring 3x less manually annotated data.

Brain MRI poses a fundamental challenge for machine learning: models must learn from high-dimensional 3D data spanning multiple co-registered modalities, despite the limited sample sizes typical of neuroimaging studies relative to the diversity in anatomy, pathology, and acquisition conditions. While multimodal imaging provides complementary information critical for clinical interpretation, effectively integrating these signals remains difficult. We propose Multimodal Intra- and Cross-Context Vision Transformer (MICViT), a 3D vision transformer that explicitly models both modality-specific representations and cross-modal interactions across local and global contexts. Concretely, MICViT combines four attention mechanisms: modality-specific local and global attention for intra-modal feature learning, and cross-modal local and global attention to capture interactions between modalities. We evaluate MICViT on brain age prediction across three heterogeneous datasets (UK Biobank, n=41,404; SOOP, n=1,062; Cam-CAN, n=613) using multiple MRI modalities (e.g. T1, FLAIR, DWI, SWI). MICViT consistently outperforms state-of-the-art CNN and transformer baselines in 3D settings. Notably, it benefits more strongly from multimodal inputs, yielding larger performance gains as additional modalities are incorporated. These results demonstrate that explicitly modeling intra- and cross-modal interactions is key to unlocking the full potential of multimodal brain MRI, highlighting a promising direction for representation learning in neuroimaging.

Language-model representations provide structured, high-dimensional annotations of naturalistic language stimuli and can serve as informative neural predictors during comprehension. We analyzed locked derived data from Brain Treebank, MEG-MASC, and Podcast ECoG with eight frozen language models, blocked encoding models, and matched temporal, nuisance, and representation-capacity controls. Positive held-out prediction and gains over low-level baselines were widespread in source-level summaries. Across Brain Treebank and Podcast ECoG, 67 of 432 evaluable rows met a controlled predictive-only criterion, and model-side feature ablations changed prediction scores in most evaluable source rows. Brain-derived, timing-linked, acoustic, and implanted-signal controls confirmed component-level sensitivity of the analysis pipeline. These findings show that language-model-derived quantities can annotate neural activity during natural speech and text comprehension. Participant-level matched-control advantages were localized rather than uniform, response-profile and feature-specificity contrasts bounded representational or computational interpretations, and complete co-indexed integrated interpretation will require future jointly indexed coverage. Together, the analyses identify language-model features as useful neural predictors and separate predictive usefulness from claims about shared neural organization or language-processing computations.

Cognitive tasks are organized by shared and specialized neural processes. Masked fMRI reconstruction provides a common self-supervised objective for quantifying transfer relations among task states, but existing reconstruction-based taskonomies mainly study one-to-one transfer from a single source task to a target. Here, we extend an fMRI cognitive taskonomy from single-source to multi-source transfer across 23 Human Connectome Project task states and use Boolean Integer Programming (BIP) to analyze budget-constrained task allocation. We train 1,127 task-specific and transfer models. Single-source transfer is directional and paradigm structured: motor states transfer well within the motor paradigm but provide limited support to most non-motor targets, consistent with a shared sensorimotor execution system and effector-specific representations. Multi-source transfer depends on the composition of the source set, suggesting that many-to-one task relations are not fully captured by pairwise taskonomy alone. Across supervision budgets, BIP repeatedly allocates direct supervision to several 0-back and 2-back working-memory states, although these states are not consistently the strongest individual sources. This pattern may reflect the integration of perceptual, attentional, and executive processes in working-memory tasks. Together, these findings reveal a cross-paradigm-limited motor cluster and working-memory states with high priority under the specified global allocation objective. Our study extends reconstruction-based fMRI taskonomy from one-to-one transfer to many-to-one task relations and budget-constrained task dependencies.

Reconstructing diffusion tensors from sparse DWIs is critical for accelerating Diffusion Tensor Imaging (DTI) in clinical settings, yet current deep learning approaches frequently yield anatomically inconsistent or physically implausible tensors. We introduce TensorLDM, a component-wise latent diffusion model that processes the six tensor components through two group-specific encoders (for diagonal and off-diagonal elements) while maintaining anatomical consistency via shared DWI conditioning. TensorLDM uses an Anatomy-Conditioned Autoencoder that encourages the latent to focus on tensor properties rather than re-encoding structural information. A shared Cross-Component Attention (CCA) mechanism, applied in both autoencoder refinement and diffusion fine-tuning, models inter-component dependencies, while a Mixture-of-Experts (MoE) DWI conditioner provides component-adaptive conditioning. On the Human Connectome Project (HCP) dataset under a single-shell, four-volume sparse acquisition, TensorLDM produces the most accurate downstream tractography and tensors with near-ground-truth physical validity (SPD-violation rate 1.54% vs. 1.40%), with the best or comparable voxel-wise reconstruction accuracy. Geodesic tensor error measured by the Log-Euclidean Metric (LEM) corroborates these gains.

Accurate segmentation of subcortical regions is critical for neurosurgical planning and functional research. Most automated methods rely on template space coregistration, which may compromise patient-specific accuracy, particularly in small structures. We identify a need to evaluate whether native space approaches offer a measurable advantage, which we evaluate in the context of movement disorders. We developed two UNet-based segmentation pipelines of the Subthalamic Nucleus (STN) - a common surgical target in Parkinson's Disease - and the neighbouring Red Nucleus (RN) and Substantia Nigra (SN). We collected 7T and 3T MRI data from five public datasets. The pipelines were evaluated in the native-space against manual labels. We further investigated the effect of the template resolution. Motivated by the hypothesis that models may better learn target boundaries in higher field, we tested the transferability of 7T-trained models to 3T clinical images, and whether synthetic 3T training data - generated via a disentangled representation learning method - could help bridging this domain gap. On held-out 7T data, the native pipeline consistently outperformed the template one. For the STN, native-space Dice reached 0.775 +- 0.055 versus 0.713 +- 0.051 (1 mm template), with HD95 of 0.79 +- 0.24 mm versus 1.17 +- 1.10 mm, respectively. Similar advantages were observed for the RN and SN. Increasing template resolution did not improve accuracy. When applied to 3T images, all models showed a considerable performance drop. Adding synthetic 3T data yielded only modest improvements, though without degrading 7T performance. Native-space segmentation is preferable for applications requiring patient specific anatomical fidelity, such as the surgical planning in PD. Bridging the 7T-to-3T domain gap remains an open challenge, motivating future work on domain adaptation tailored to subcortical structures.

We introduce SMART, a framework for learning a flexible, interpretable, and scalable spatio-temporal brain atlas from longitudinal high-resolution 3D medical images. Existing approaches to spatio-temporal atlas construction rely on black-box generative models that lack flexibility, limit interpretability, and struggle to scale to high-dimensional data. SMART addresses these challenges by learning a continuous disease-time atlas that decouples global group-wise disease dynamics from their patient-specific anatomical manifestation. Guided by anatomically inspired priors, SMART models interpretable global trajectories of regional progression along a shared disease timeline through region-specific differential equations. Global trajectories are further personalized to individual anatomies via dense diffeomorphic displacements parameterized by a flexible and scalable multi-scale Neural Cellular Automata. Evaluated on five longitudinal MRI datasets in Alzheimer's disease (ADNI-1/GO/2, OASIS-3, AIBL; > 1,300 subjects), SMART produces anatomically meaningful predictions of disease progression and achieves state-of-the-art forecasting accuracy and improved temporal consistency over adversarial and diffusion baselines. Our approach establishes a new paradigm for flexible, interpretable, and scalable modeling of spatio-temporal change in high-dimensional medical image time-series.

Despite increasing adoption of multimodal approaches in Alzheimer's Disease (AD) research -- aimed at integrating molecular, structural, clinical, and genetic biomarkers to enhance disease characterization -- the relationships among these modalities remain poorly understood. A systematic analysis of their dynamic interaction is essential for improving disease modeling, identifying redundant assessments, and reducing patient burden and acquisition costs. In this paper, we present a quantitative analysis of multimodal AD biomarkers by integrating tau-PET, structural MRI, cognitive scores (MMSE and CDR), and APOE4 data from 789 subjects drawn from the ADNI dataset. In our analyses, we (A) quantify cross-modal mutual information and explained variance to assess redundancy and predictive dependencies; (B) examine associations between tau topologies and structural atrophy across brain regions to select informative ROIs; (C) perform a statistical decomposition of the tau-cognition association into atrophy-related and atrophy-independent components; (D) and identify a dominant neurodegenerative trajectory that aligns with cognitive decline. This study provides a systematic characterization of cross-modal relationships, improving the interpretability and selection of biomarkers in AD. Code is publicly available at: https://github.com/antonioscardace/Multimodal-AD.

Whole-brain 4D fMRI generation is valuable for modeling functional brain dynamics, yet existing fMRI foundation models mainly target representation learning and downstream prediction rather than conditional predictive generation. We introduce BrainWorld, a structural-prior-conditioned generative model for whole-brain 4D fMRI dynamics. BrainWorld uses sMRI as subject-level anatomical context to guide future fMRI generation, integrating structural information into the denoising process rather than treating it as a parallel modality. Evaluated on 22 datasets spanning diverse cohorts and brain states, BrainWorld generates stable 4D fMRI trajectories up to 400 frames, improves downstream performance through generated-example augmentation, and learns transferable multimodal representations that outperform baselines. Together, these results establish BrainWorld as a condition-aware generative framework for long-horizon brain dynamics modeling and multimodal representation learning.

Tau positron emission tomography (PET) is widely used for the in vivo characterization of disease stage and progression in Alzheimer's disease (AD). With the adoption of multiple tau PET tracers including AV-1451, PI-2620, MK-6240 with different binding behaviors in various large-scale studies, there is a great need of effective harmonization methods to enable the cross-tracer integration of tau PET datasets. While previous methods such as CenTauR were proposed to standardize scalar tau PET measures, they are limited in accounting for the heterogeneity of tau pathology. In this work, we propose Feynman-Kac Reweighted Schrödinger Bridge Matching (FKRSBM), a surface-based framework for cross-tracer tau PET harmonization. FKRSBM learns a direct stochastic transport between tracer domains using Schrödinger Bridge matching, avoiding the Gaussian-prior routing used in diffusion-based translation. To promote biologically consistent transport, FKRSBM introduces an endpoint penalty favoring bridge pairings with matched tau-pathology status and implements it through a Feynman-Kac reweighted endpoint proposal. To preserve cortical organization, FKRSBM uses a spherical convolutional network for vertex-level harmonization on cortical surface meshes. In our experiments, we demonstrate our method by harmonizing Tau PET images acquired with the AV-1451 (n=1480) and PI-2620 (n=2458) tracers from two large-scale datasets. Compared to previous methods including ComBat, CycleGAN, Diffusion Model(DF), and unregularized Schrödinger Bridge Model(DSBM), the proposed FKRSBM method outperforms these baselines in subgroup-level alignment, tau-positivity consistency, and diagnostic classification while preserving subject-specific cortical topography of tau pathology. The code is available at: https://github.com/jianweizhang17/FKRSBM.

Decoding inner speech from non-invasive brain signals remains a fundamental challenge due to the absence of overt linguistic output, limited training data, and large inter-subject variability. Existing brain-to-text approaches often rely on task-specific decoder fine-tuning, which restricts scalability and complicates adaptation to new participants. We propose MindAlign, a decoupled two-stage brain-to-language framework that enables open-ended text generation from fMRI signals without modifying the underlying language model. The first stage learns a subject-specific neural-semantic alignment that maps fMRI activity into a shared multimodal semantic space, extracting a latent semantic sketch of the internally generated sentence. The second stage integrates this sketch with visual context to prompt a frozen multimodal language model for free-form generation. Experiments on fMRI data collected during silent image description demonstrate that the proposed approach consistently outperforms fMRI-only and random baselines. We further show that the learned semantic-to-language projection can generalize across subjects, enabling effective decoding when paired with subject-specific neural alignment. These results indicate that neural signals modulate semantic content beyond image-driven priors, supporting a scalable and modular direction for brain-to-text decoding.

This study examines how deficiencies in one brain connectome modality propagate to the other, using the Krakencoder as a simulation framework. Structural and functional connectomes from 702 healthy participants in the Human Connectome Project were analyzed, with the impact of each of the Yeo-7 functional networks assessed separately. Seven scenarios were considered, each involving the removal of a single network while the remaining networks were preserved. The resulting perturbations in cross-modal predictions were quantified using three complementary metrics: KL divergence on eigenvalue spectra, Frobenius norm, and Wasserstein distance. In addition, the persistence of sex-specific information within the predicted connectomes was evaluated. Across all metrics and both prediction directions, the Default Mode Network produced the largest perturbations, whereas the Somatomotor network yielded the smallest. Sex differences in network-level perturbation signatures were subtle, with the best result being an accuracy of 66.09% from connectomes predicted under network-removal conditions. In contrast, connectomes predicted from intact inputs achieved substantially higher sex classification accuracy, reaching up to 84.76%. These findings confirm that full predicted connectomes retain considerably more sex-discriminative information than perturbation-derived signatures alone.

Post-traumatic epilepsy (PTE) is a severe complication of traumatic brain injury (TBI). Yet, early identification remains challenging due to the complex structural and functional alterations it induces in the brain. To address this, we propose a dynamic multimodal Mixture-of-Experts (MoE) framework that integrates functional and structural connectivity through time-aware functional-structural encoding and class-conditioned expert routing. Within this framework, modality-specific and cross-modal experts learn complementary representations, while a Modality-Class MoE (MCoE) module dynamically adjusts expert weights according to each classification objective. Experimental results across three binary classification tasks demonstrate that the framework consistently outperforms static fusion baselines, and high-interpretability analyses further reveal meaningful regions of interest (ROIs) interactions. This dynamic multimodal expert framework effectively captures class-dependent brain interaction patterns and provides an interpretable approach for PTE diagnosis and risk stratification.

Alzheimer's disease (AD) progression is often described through the amyloid-tau-neurodegeneration, or AT(N), cascade. However, most longitudinal models represent this cascade either as a fixed sequence of biomarkers or as a black-box forecasting task. This makes it difficult to determine when biologically guided biomarker relationships influence future regional pathology. In this study, we introduce Bayesian Networks with Latent Time Embedding (BN-LTE), a Bayesian structural framework for stage-aware modeling of AD progression. BN-LTE estimates disease pseudotime from baseline biomarker profiles and constrains directed dependencies according to biologically plausible AT(N) ordering. Posterior spline-varying structural equations are then used to link initial multimodal measurements with future annualized regional tau-PET change. Across repeated subject-disjoint evaluations using ADNI data, BN-LTE shows strong spatial reconstruction of tau progression compared with the included forecasting baselines. Beyond spatial reconstruction, BN-LTE recovers posterior stage-varying AT(N)-constrained effects and identifies a mid-pseudotime window of amyloid sensitivity. This window is supported by model-implied g-formula contrasts, root-adjusted AIPW, mechanism-sensitive ablations, and robustness analyses across spline and prior specifications. Overall, these findings position BN-LTE as a Bayesian structural framework for forecasting tau progression while examining stage-dependent AT(N)-cascade mechanisms in observational longitudinal neuroimaging data. Our code is available at https://github.com/danleneurocom/BN-LTE.

3D FLAIR MRI is widely recommended as one of the standard MRI sequences for brain imaging in multiple sclerosis (MS), but publicly available MS datasets remain relatively small and vary across scanners, acquisition protocols, and lesion patterns. This scarcity and variability hinder the development of robust neuroimaging machine learning models and are particularly challenging for generative models that aim to synthesize images while preserving small, sparse lesions. We propose Lesion-DDPM, a 3D conditional diffusion framework for lesion-aware FLAIR synthesis that incorporates multi-level anatomical mask injection together with a lesion-weighted reconstruction loss to emphasize lesion voxels while maintaining global brain structure. Using a curated subset of the MSLesSeg dataset, we compare Lesion-DDPM with representative state-of-the-art GAN- and diffusion-based models, assessing both image-generation metrics and downstream 3D U-Net segmentation. In our experiments, Lesion-DDPM achieved the lowest lesion-region reconstruction error among all methods. In a downstream 3D U-Net lesion segmentation task, a model trained only on Lesion-DDPM-generated scans and evaluated on real MRIs reached a Dice score of 0.616 compared with 0.569 for the best competing synthetic dataset. When Lesion-DDPM images were added to the real training set, the Dice score further increased to 0.685.

Brain MRIs are routinely acquired as multiple complementary sequences with unique contrast weighting, including T1-weighed imaging (T1w) anatomic and fluid-sensitive T2-weighted (T2w) contrasts. However, methods for learning unified representations across the multitude of MRI contrast mechanisms at health-system scale are lacking. In this study, we introduce Neuro-JEPA, a sparse multimodal neuroimaging foundation model that combines a latent predictive objective with a Mixture-of-Experts architecture to encode brain MRI across core T1w, T2w, and fluid-suppressed FLAIR imaging (FLAIR). We further provide a systematic methodological study of architectural, masking, objective, and sparsity design choices beneficial for robust neuroimaging multimodal representation learning. Neuro-JEPA was pretrained on 1,551,862 scans from 428,647 studies after modality-specific preprocessing with data curation across three core structural brain MRI sequences. We evaluated the learned representations across clinical and research settings, including 25 tasks from three health systems: NYU Langone, NYU Long Island, and Massachusetts General Hospital, and 22 tasks from 12 public datasets, covering unimodal, multimodal and cross-domain evaluation configurations. Across these benchmarks, existing neuroimaging foundation models showed inconsistent gains over a simple convolutional neural network (CNN) baseline, whereas Neuro-JEPA achieved stronger and more consistent performance across all evaluated settings. These results establish a scalable methodological framework for multimodal neuroimaging representation learning and highlight the need for foundation model evaluation protocols that include simple baselines, clinically heterogeneous cohorts and controlled multimodal comparisons.

Alzheimer's Disease (AD) is a complex neurodegenerative disorder that continues to impact millions of people worldwide. Predicting AD conversion during the prodromal stage remains critical for disease understanding and patient care. As such, survival models are widely used for AD risk prediction, yet they are typically static predictors with limited interpretability and no capacity for natural language reasoning. In this work, we propose iLENS, an interpretable large language model (LLM) guided framework based on mixture-of-experts (MoE) for survival prediction in AD conversion. Our approach uses LLM to synthesize structured neuroimaging measurements and unstructured information to guide expert routing. Our framework demonstrates competitive predictive performance and capability in patient subtyping. Furthermore, our framework provides transparent, biologically grounded rationales for its routing decisions, bridging the gap between high-performance survival analysis and interpretable clinical decision support.

Leptomeningeal collaterals (LMCs) are an important prognostic factor in acute ischemic stroke. Existing automated methods rely on CT angiography (CTA), but individual LMCs are often too small to be resolved on CTA, limiting these methods to coarse collateral scoring. Digital subtraction angiography (DSA) visualizes individual collaterals at superior resolution, yet current assessment remains subjective, relying on manual grading scales that suffer from poor inter-rater agreement. We present a framework that formulates collateral detection as the classification of individual vessel segments on a graph derived from DSA. A hybrid graph-pixel architecture combines a topology-aware graph branch with a dense pixel branch, fused in a shared node-probability space. In a five-fold cross-validation setting, the fused model achieves a PR-AUC of 0.434, outperforming the graph-only (0.403) and pixel-only (0.362) baselines. To our knowledge, this is the first method to enable the individualization of LMCs in DSA, allowing for precise per-vessel quantitative assessment. This integration shifts DSA assessment toward objective evaluation, supporting future biomarker and pattern discovery for individual LMCs.

This paper presents a two-stage Hybrid Classical-Quantum (HCQ) pipeline for binary Alzheimer's disease (AD) classification from 3D T1-weighted structural MRI volumes, where the classical and quantum components are designed to complement each other rather than operate independently. A supervised 3D $β$-variational autoencoder (VAE) is trained end-to-end under voxel-wise reconstruction, KL-divergence, and focal classification losses that compress each 3D MRI volume (resized from 152 x 184 x 152 to 96 x 96 x 96) into a 64-dimensional latent code. Partial Least Squares (PLS) regression selects the six components in the latent code that best separate Alzheimer's Disease (AD) from cognitively normal (CN) subjects and rescales them into rotation angles, which are encoded onto a six-qubit register using the ZZ quantum feature map to give us the respective quantum states. The input to a precomputed-kernel Support Vector Machine (SVM) is an N x N Gram matrix (N = 308), created by calculating the overlap between every pair of quantum states. The novelty of this work lies in the fact that the quantum kernel operates directly on disease-aware features that are learned end-to-end by a supervised autoencoder, rather than on pre-extracted inputs. On 308 ADNI-1 subjects, consisting of 137 AD and 171 CN subjects, the baseline achieved 67.2% accuracy and 0.759 AUC, while the stability-enhanced variant reached 72.1% accuracy and 0.799 AUC with cross-fold variance halved. 3D Grad-CAM further helped validate our model's focus on brain regions linked to Alzheimer's. The HCQ pipeline could serve as a general-purpose framework for diagnostic classification across biomedical imaging domains that present similar challenges for classical approaches.

Multimodal neuroimaging, integrating functional connectivity from fMRI and structural connectivity from DTI, enables non-invasive analysis of brain networks using graph neural networks. However, demographic factors such as age and sex systematically confound the relationship between brain connectivity and clinical outcomes, causing GNNs to exploit spurious shortcuts rather than learning causally invariant representations. While recent causal GNN methods introduce causality at the graph-modeling level, their causal mechanisms remain domain-agnostic without accounting for the real-world confounders inherent in clinical neuroimaging data. Moreover, brain networks are constructed from atlas-based parcellations where each region exhibits distinct sensitivity to demographic factors, necessitating region-aware adjustment. We propose Artemis, a region-level causal framework that bridges this gap with causal intervention at each brain region independently by learning region-specific confounder representations with lightweight parameters. Our adjustment comprehensively utilized the multimodal functional and structural features for graph reasoning as a plug-in module compatible with arbitrary GNN backbones. Experiments on three benchmarks, ADNI for disease diagnosis, OASIS for dementia staging, and HCP for sex classification, demonstrate consistent improvements over representative GNN-based baselines. Multiple supporting experiments further demonstrate statistical significance and neuroscientific interpretability.

The success of large-scale deep learning models in neuroscience is fundamentally constrained by severe data heterogeneity. Native fMRI data aggregated from diverse sources exhibit substantial variation in both spatial and temporal resolutions. Consequently, most existing frameworks rely on lengthy, rigid preprocessing pipelines that enforce uniformity across datasets. This practice introduces two critical limitations: (1) potential degradation of subject-specific anatomical information; (2) significant computational overhead, often requiring hours of processing per subject. Here, we propose FlexiBrain, a resolution-agnostic voxel-level encoding framework for native fMRI based on Mamba-JEPA. FlexiBrain defines patch sizes in real-world physical units and employs a dynamic patch resizing, thereby bypassing destructive spatial standardization while enabling direct ingestion of data in native space. We instantiate the framework using an efficient Mamba-JEPA backbone to model high-dimensional 4D fMRI signals. Across five diverse downstream neuroscience tasks, FlexiBrain consistently outperforms recent state-of-the-art methods, achieving gains of up to 12 percentage points without external data augmentation. Importantly, FlexiBrain functions as a seamless plug-in module, substantially reducing preprocessing costs and accelerating the development of robust voxel-level fMRI foundation models. Code is available at https://github.com/OneMore1/FlexiBrain.

Accelerated acquisition of fMRI enables enhanced detection of neurovascular (BOLD) activity in the brain, but image reconstruction becomes challenging with high k-space undersampling: Task-evoked BOLD signals are small in magnitude, which traditional anatomical MRI reconstruction methods fail to recover, as they favor spatial accuracy over temporal fidelity. We present DD-INR, a Dynamics-Driven Implicit Neural Representation framework tailored for accelerated fMRI that benefits from incoherent time-varying sampling and a tailored spatiotemporal prior, outperforming traditional methods, demonstrated in simulation and in-vivo acquisition, both in terms of image quality and retrieval of activation patterns. DD-INR achieves this by splitting the fMRI data into a static background and a temporally varying dynamic component, representing only the dynamics with a dedicated INR, thereby focusing the model's capacity on activation-relevant changes while remaining compact. In general, DD-INR provides a promising framework for accelerated fMRI reconstruction, with the potential to improve the sensitivity and robustness of fMRI studies within practical scan time limits. The source code is available at https://github.com/JoosenLi/DD-INR.

Cortical folding reflects coordinated neurodevelopmental processes and is increasingly recognized as a sensitive marker of neurological disease. However, most existing analyses rely on indirect scalar summaries that do not explicitly model folding geometry itself. In juvenile myoclonic epilepsy (JME), a common genetic epilepsy, cortical abnormalities are often subtle, spatially distributed, and difficult to detect using conventional morphometric measures. We introduce a Poisson-equation--based framework that models cortical folding as a geometry-driven flow derived from mean curvature on the cortical manifold. By treating folding patterns as a stationary source--sink structure, the proposed approach yields a smooth, globally balanced potential field whose surface gradient defines a physically interpretable flux. This framework enables spatially coherent analysis of sulcal--gyral folding organization and provides a principled representation of geometry-driven cortical structure in JME.

Decoding emotional states from neural signals has been typically framed as a discrete, single-label classification task based on emotionally stable stimuli, a formulation that oversimplifies the continuous, fluid, and co-occurring nature of human affect. This study reconceptualizes emotion decoding by adopting a multi-target regression framework to track multiple overlapping emotional dimensions as continuous trajectories over time. Leveraging the robust generalization capabilities of Large Language Models (LLMs), we extracted fine-grained, continuous sentiment profiles from a naturalistic auditory narrative, Alice in Wonderland, to serve as scalable proxies for subjective affect from human fMRI dataset. Departing from standard classification paradigms or mass-univariate subtractive contrasts that filter out network dynamics, we leverage regularized and kernel-based machine learning algorithms as continuous estimators to track the magnitude of macroscale neural state variations. We demonstrate that models trained on temporal snapshots of Dynamic Functional Connectivity (DFC) significantly outperform static region-of-interest (ROI) amplitude representations, effectively capturing continuous emotional trajectories under rapidly fluctuating narrative input. Furthermore, by implementing graph-theoretical Explainable AI (XAI) techniques, we deconstruct the underlying predictive features to reveal highly interpretable, emotion-specific topological configurations. Collectively, these results highlight the utility of LLM-automated annotation in affective neuroscience and provide compelling empirical evidence for psychological constructionist frameworks, demonstrating that dynamic, distributed network interactions offer superior explanatory power over strictly locationist accounts of emotion.