Daily Papers

Forecasting epileptic seizures from multivariate EEG signals represents a critical challenge in healthcare time series prediction, requiring high sensitivity, low false alarm rates, and subject-specific adaptability. We present STAN, an Adversarial Spatio-Temporal Attention Network that jointly models spatial brain connectivity and temporal neural dynamics through cascaded attention blocks with alternating spatial and temporal modules. Unlike existing approaches that assume fixed preictal durations or separately process spatial and temporal features, STAN captures bidirectional dependencies between spatial and temporal patterns through a unified cascaded architecture. Adversarial training with gradient penalty enables robust discrimination between interictal and preictal states learned from clearly defined 15-minute preictal windows. Continuous 90-minute pre-seizure monitoring reveals that the learned spatio-temporal attention patterns enable early detection: reliable alarms trigger at subject-specific times (typically 15-45 minutes before onset), reflecting the model's capacity to capture subtle preictal dynamics without requiring individualized training. Experiments on two benchmark EEG datasets (CHB-MIT scalp: 8 subjects, 46 events; MSSM intracranial: 4 subjects, 14 events) demonstrate state-of-the-art performance: 96.6% sensitivity with 0.011 false detections per hour and 94.2% sensitivity with 0.063 false detections per hour, respectively, while maintaining computational efficiency (2.3M parameters, 45 ms latency, 180 MB memory) for real-time edge deployment. Beyond epilepsy, the proposed framework provides a general paradigm for spatio-temporal forecasting in healthcare and other time series domains where individual heterogeneity and interpretability are crucial.

This paper presents Non-Attentive Tacotron based on the Tacotron 2 text-to-speech model, replacing the attention mechanism with an explicit duration predictor. This improves robustness significantly as measured by unaligned duration ratio and word deletion rate, two metrics introduced in this paper for large-scale robustness evaluation using a pre-trained speech recognition model. With the use of Gaussian upsampling, Non-Attentive Tacotron achieves a 5-scale mean opinion score for naturalness of 4.41, slightly outperforming Tacotron 2. The duration predictor enables both utterance-wide and per-phoneme control of duration at inference time. When accurate target durations are scarce or unavailable in the training data, we propose a method using a fine-grained variational auto-encoder to train the duration predictor in a semi-supervised or unsupervised manner, with results almost as good as supervised training.

Reliable automatic seizure detection from long-term EEG remains a challenge, as current machine learning models often fail to generalize across patients or clinical settings. Manual EEG review remains the clinical standard, underscoring the need for robust models and standardized evaluation. To rigorously assess algorithm performance, we organized a challenge using a private dataset of continuous EEG recordings from 65 subjects (4,360 hours). Expert neurophysiologists annotated the data, providing ground truth for seizure events. Participants were required to detect seizure onset and duration, with evaluation based on event-based metrics, including sensitivity, precision, F1-score, and false positives per day. The SzCORE framework ensured standardized evaluation. The primary ranking criterion was the event-based F1-score, reflecting clinical relevance by balancing sensitivity and false positives. The challenge received 30 submissions from 19 teams, with 28 algorithms evaluated. Results revealed wide variability in performance, with a top F1-score of 43% (sensitivity 37%, precision 45%), highlighting the ongoing difficulty of seizure detection. The challenge also revealed a gap between reported performance and real-world evaluation, emphasizing the importance of rigorous benchmarking. Compared to previous challenges and commercial systems, the best-performing algorithm in this contest showed improved performance. Importantly, the challenge platform now supports continuous benchmarking, enabling reproducible research, integration of new datasets, and clinical evaluation of seizure detection algorithms using a standardized framework.

Clinical brain-to-text interfaces are designed for paralysed patients who cannot provide extensive training recordings. Pre-training improves data-efficient generalisation by learning statistical priors across subjects, but these priors critically depend on context. While natural speech might unfold gradually over minutes, most methods pre-train with only a few seconds of context. Thus, we propose MEG-XL, a model pre-trained with 2.5 minutes of MEG context per sample, 5-300x longer than prior work, and equivalent to 191k tokens, capturing extended neural context. Fine-tuning on the task of word decoding from brain data, MEG-XL matches supervised performance with a fraction of the data (e.g. 1hr vs 50hrs) and outperforms brain foundation models. We find that models pre-trained with longer contexts learn representations that transfer better to word decoding. Our results indicate that long-context pre-training helps exploit extended neural context that other methods unnecessarily discard. Code, model weights, and instructions are available at https://github.com/neural-processing-lab/MEG-XL .

With the advent of LLMs, various tasks across the natural language processing domain have been transformed. However, their application in predictive tasks remains less researched. This study compares large language models, including GatorTron-Base (trained on clinical data), Llama 8B, and Mistral 7B, against models like BioBERT, DocBERT, BioClinicalBERT, Word2Vec, and Doc2Vec, setting benchmarks for predicting Shock in critically ill patients. Timely prediction of shock can enable early interventions, thus improving patient outcomes. Text data from 17,294 ICU stays of patients in the MIMIC III database were scored for length of stay > 24 hours and shock index (SI) > 0.7 to yield 355 and 87 patients with normal and abnormal SI-index, respectively. Both focal and cross-entropy losses were used during finetuning to address class imbalances. Our findings indicate that while GatorTron Base achieved the highest weighted recall of 80.5%, the overall performance metrics were comparable between SLMs and LLMs. This suggests that LLMs are not inherently superior to SLMs in predicting future clinical events despite their strong performance on text-based tasks. To achieve meaningful clinical outcomes, future efforts in training LLMs should prioritize developing models capable of predicting clinical trajectories rather than focusing on simpler tasks such as named entity recognition or phenotyping.

Lung cancer patients frequently experience breakthrough pain episodes, with up to 91% requiring timely intervention. To enable proactive pain management, we propose a hybrid machine learning and large language model pipeline that predicts pain episodes within 48 and 72 hours of hospitalization using both structured and unstructured electronic health record data. A retrospective cohort of 266 inpatients was analyzed, with features including demographics, tumor stage, vital signs, and WHO-tiered analgesic use. The machine learning module captured temporal medication trends, while the large language model interpreted ambiguous dosing records and free-text clinical notes. Integrating these modalities improved sensitivity and interpretability. Our framework achieved an accuracy of 0.874 (48h) and 0.917 (72h), with an improvement in sensitivity of 8.6% and 10.4% due to the augmentation of large language model. This hybrid approach offers a clinically interpretable and scalable tool for early pain episode forecasting, with potential to enhance treatment precision and optimize resource allocation in oncology care.

We present the Brain Treebank, a large-scale dataset of electrophysiological neural responses, recorded from intracranial probes while 10 subjects watched one or more Hollywood movies. Subjects watched on average 2.6 Hollywood movies, for an average viewing time of 4.3 hours, and a total of 43 hours. The audio track for each movie was transcribed with manual corrections. Word onsets were manually annotated on spectrograms of the audio track for each movie. Each transcript was automatically parsed and manually corrected into the universal dependencies (UD) formalism, assigning a part of speech to every word and a dependency parse to every sentence. In total, subjects heard over 38,000 sentences (223,000 words), while they had on average 168 electrodes implanted. This is the largest dataset of intracranial recordings featuring grounded naturalistic language, one of the largest English UD treebanks in general, and one of only a few UD treebanks aligned to multimodal features. We hope that this dataset serves as a bridge between linguistic concepts, perception, and their neural representations. To that end, we present an analysis of which electrodes are sensitive to language features while also mapping out a rough time course of language processing across these electrodes. The Brain Treebank is available at https://BrainTreebank.dev/

Magnetic resonance imaging (MRI) is a crucial tool to identify brain abnormalities in a wide range of neurological disorders. In focal epilepsy MRI is used to identify structural cerebral abnormalities. For covert lesions, machine learning and artificial intelligence algorithms may improve lesion detection if abnormalities are not evident on visual inspection. The success of this approach depends on the volume and quality of training data. Herein, we release an open-source dataset of preprocessed MRI scans from 442 individuals with drug-refractory focal epilepsy who had neurosurgical resections, and detailed demographic information. The MRI scan data includes the preoperative 3D T1 and where available 3D FLAIR, as well as a manually inspected complete surface reconstruction and volumetric parcellations. Demographic information includes age, sex, age of onset of epilepsy, location of surgery, histopathology of resected specimen, occurrence and frequency of focal seizures with and without impairment of awareness, focal to bilateral tonic-clonic seizures, number of anti-seizure medications (ASMs) at time of surgery, and a total of 1764 patient years of post-surgical follow up. Crucially, we also include resection masks delineated from post-surgical imaging. To demonstrate the veracity of our data, we successfully replicated previous studies showing long-term outcomes of seizure freedom in the range of around 50%. Our imaging data replicates findings of group level atrophy in patients compared to controls. Resection locations in the cohort were predominantly in the temporal and frontal lobes. We envisage our dataset, shared openly with the community, will catalyse the development and application of computational methods in clinical neurology.

Spectrograms are pivotal in time-frequency signal analysis, widely used in audio processing and computational neuroscience. Chirp-like patterns in electroencephalogram (EEG) spectrograms (marked by linear or exponential frequency sweep) are key biomarkers for seizure dynamics, but automated tools for their detection, localization, and feature extraction are lacking. This study bridges this gap by fine-tuning a Vision Transformer (ViT) model on synthetic spectrograms, augmented with Low-Rank Adaptation (LoRA) to boost adaptability. We generated 100000 synthetic spectrograms with chirp parameters, creating the first large-scale benchmark for chirp localization. These spectrograms mimic neural chirps using linear or exponential frequency sweep, Gaussian noise, and smoothing. A ViT model, adapted for regression, predicted chirp parameters. LoRA fine-tuned the attention layers, enabling efficient updates to the pre-trained backbone. Training used MSE loss and the AdamW optimizer, with a learning rate scheduler and early stopping to curb overfitting. Only three features were targeted: Chirp Start Time (Onset Time), Chirp Start Frequency (Onset Frequency), and Chirp End Frequency (Offset Frequency). Performance was evaluated via Pearson correlation between predicted and actual labels. Results showed strong alignment: 0.9841 correlation for chirp start time, with stable inference times (137 to 140s) and minimal bias in error distributions. This approach offers a tool for chirp analysis in EEG time-frequency representation, filling a critical methodological void.

Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting 35% of extremely low birth weight infants. Defined by oxygen dependence at 36 weeks postmenstrual age, it causes lifelong respiratory complications. However, preventive interventions carry severe risks, including neurodevelopmental impairment, ventilator-induced lung injury, and systemic complications. Therefore, early BPD prognosis and prediction of BPD outcome is crucial to avoid unnecessary toxicity in low risk infants. Admission radiographs of extremely preterm infants are routinely acquired within 24h of life and could serve as a non-invasive prognostic tool. In this work, we developed and investigated a deep learning approach using chest X-rays from 163 extremely low-birth-weight infants (leq32 weeks gestation, 401-999g) obtained within 24 hours of birth. We fine-tuned a ResNet-50 pretrained specifically on adult chest radiographs, employing progressive layer freezing with discriminative learning rates to prevent overfitting and evaluated a CutMix augmentation and linear probing. For moderate/severe BPD outcome prediction, our best performing model with progressive freezing, linear probing and CutMix achieved an AUROC of 0.78 pm 0.10, balanced accuracy of 0.69 pm 0.10, and an F1-score of 0.67 pm 0.11. In-domain pre-training significantly outperformed ImageNet initialization (p = 0.031) which confirms domain-specific pretraining to be important for BPD outcome prediction. Routine IRDS grades showed limited prognostic value (AUROC 0.57 pm 0.11), confirming the need of learned markers. Our approach demonstrates that domain-specific pretraining enables accurate BPD prediction from routine day-1 radiographs. Through progressive freezing and linear probing, the method remains computationally feasible for site-level implementation and future federated learning deployments.

Foundation models have transformed AI by reducing reliance on task-specific data through large-scale pretraining. While successful in language and vision, their adoption in EEG has lagged due to the heterogeneity of public datasets, which are collected under varying protocols, devices, and electrode configurations. Existing EEG foundation models struggle to generalize across these variations, often restricting pretraining to a single setup, resulting in suboptimal performance, in particular under linear probing. We present REVE (Representation for EEG with Versatile Embeddings), a pretrained model explicitly designed to generalize across diverse EEG signals. REVE introduces a novel 4D positional encoding scheme that enables it to process signals of arbitrary length and electrode arrangement. Using a masked autoencoding objective, we pretrain REVE on over 60,000 hours of EEG data from 92 datasets spanning 25,000 subjects, representing the largest EEG pretraining effort to date. REVE achieves state-of-the-art results on 10 downstream EEG tasks, including motor imagery classification, seizure detection, sleep staging, cognitive load estimation, and emotion recognition. With little to no fine-tuning, it demonstrates strong generalization, and nuanced spatio-temporal modeling. We release code, pretrained weights, and tutorials to support standardized EEG research and accelerate progress in clinical neuroscience.

Models that can predict the occurrence of events ahead of time with low false-alarm rates are critical to the acceptance of decision support systems in the medical community. This challenging task is typically treated as a simple binary classification, ignoring temporal dependencies between samples, whereas we propose to exploit this structure. We first introduce a common theoretical framework unifying dynamic survival analysis and early event prediction. Following an analysis of objectives from both fields, we propose Temporal Label Smoothing (TLS), a simpler, yet best-performing method that preserves prediction monotonicity over time. By focusing the objective on areas with a stronger predictive signal, TLS improves performance over all baselines on two large-scale benchmark tasks. Gains are particularly notable along clinically relevant measures, such as event recall at low false-alarm rates. TLS reduces the number of missed events by up to a factor of two over previously used approaches in early event prediction.

We present a scalable method to produce high quality emphasis for text-to-speech (TTS) that does not require recordings or annotations. Many TTS models include a phoneme duration model. A simple but effective method to achieve emphasized speech consists in increasing the predicted duration of the emphasised word. We show that this is significantly better than spectrogram modification techniques improving naturalness by 7.3% and correct testers' identification of the emphasized word in a sentence by 40% on a reference female en-US voice. We show that this technique significantly closes the gap to methods that require explicit recordings. The method proved to be scalable and preferred in all four languages tested (English, Spanish, Italian, German), for different voices and multiple speaking styles.