Sophia I. Thomopoulos

Eamonn Kennedy, Shashank Vadlamani, Hannah M Lindsey et al.

An extensive library of symptom inventories has been developed over time to measure clinical symptoms, but this variety has led to several long standing issues. Most notably, results drawn from different settings and studies are not comparable, which limits reproducibility. Here, we present an artificial intelligence (AI) approach using semantic textual similarity (STS) to link symptoms and scores across previously incongruous symptom inventories. We tested the ability of four pre-trained STS models to screen thousands of symptom description pairs for related content - a challenging task typically requiring expert panels. Models were tasked to predict symptom severity across four different inventories for 6,607 participants drawn from 16 international data sources. The STS approach achieved 74.8% accuracy across five tasks, outperforming other models tested. This work suggests that incorporating contextual, semantic information can assist expert decision-making processes, yielding gains for both general and disease-specific clinical assessment.

Roberto Goya-Maldonado, Tracy Erwin-Grabner, Ling-Li Zeng et al.

Major depressive disorder (MDD) is a complex psychiatric disorder that affects the lives of hundreds of millions of individuals around the globe. Even today, researchers debate if morphological alterations in the brain are linked to MDD, likely due to the heterogeneity of this disorder. The application of deep learning tools to neuroimaging data, capable of capturing complex non-linear patterns, has the potential to provide diagnostic and predictive biomarkers for MDD. However, previous attempts to demarcate MDD patients and healthy controls (HC) based on segmented cortical features via linear machine learning approaches have reported low accuracies. Here, we used globally representative data from the ENIGMA-MDD working group containing 7,012 participants from 30 sites (N=2,772 MDD and N=4,240 HC), which allows a comprehensive analysis with generalizable results. Based on the hypothesis that integration of vertex-wise cortical features can improve classification performance, we evaluated the classification of a DenseNet and a Support Vector Machine (SVM), with the expectation that the former would outperform the latter. We found that both classifiers exhibited close to chance performance (balanced accuracy DenseNet: 51%; SVM: 53%), when estimated on unseen sites. Slightly higher classification performance (balanced accuracy DenseNet: 58%; SVM: 55%) was found when the cross-validation folds contained subjects from all sites, indicating site effect. In conclusion, the integration of vertex-wise morphometric features and the use of the non-linear classifier did not lead to the differentiability between MDD and HC. Our results support the notion that MDD classification on this combination of such features and classifiers is unfeasible. Perhaps more sophisticated integration of multimodal information may lead to a higher performance in this diagnostic task.

Nikhil J. Dhinagar, Sophia I. Thomopoulos, Emily Laltoo et al.

Neuroimaging of large populations is valuable to identify factors that promote or resist brain disease, and to assist diagnosis, subtyping, and prognosis. Data-driven models such as convolutional neural networks (CNNs) have increasingly been applied to brain images to perform diagnostic and prognostic tasks by learning robust features. Vision transformers (ViT) - a new class of deep learning architectures - have emerged in recent years as an alternative to CNNs for several computer vision applications. Here we tested variants of the ViT architecture for a range of desired neuroimaging downstream tasks based on difficulty, in this case for sex and Alzheimer's disease (AD) classification based on 3D brain MRI. In our experiments, two vision transformer architecture variants achieved an AUC of 0.987 for sex and 0.892 for AD classification, respectively. We independently evaluated our models on data from two benchmark AD datasets. We achieved a performance boost of 5% and 9-10% upon fine-tuning vision transformer models pre-trained on synthetic (generated by a latent diffusion model) and real MRI scans, respectively. Our main contributions include testing the effects of different ViT training strategies including pre-training, data augmentation and learning rate warm-ups followed by annealing, as pertaining to the neuroimaging domain. These techniques are essential for training ViT-like models for neuroimaging applications where training data is usually limited. We also analyzed the effect of the amount of training data utilized on the test-time performance of the ViT via data-model scaling curves.

Nikhil J. Dhinagar, Amit Singh, Saket Ozarkar et al.

Transfer learning represents a recent paradigm shift in the way we build artificial intelligence (AI) systems. In contrast to training task-specific models, transfer learning involves pre-training deep learning models on a large corpus of data and minimally fine-tuning them for adaptation to specific tasks. Even so, for 3D medical imaging tasks, we do not know if it is best to pre-train models on natural images, medical images, or even synthetically generated MRI scans or video data. To evaluate these alternatives, here we benchmarked vision transformers (ViTs) and convolutional neural networks (CNNs), initialized with varied upstream pre-training approaches. These methods were then adapted to three unique downstream neuroimaging tasks with a range of difficulty: Alzheimer's disease (AD) and Parkinson's disease (PD) classification, "brain age" prediction. Experimental tests led to the following key observations: 1. Pre-training improved performance across all tasks including a boost of 7.4% for AD classification and 4.6% for PD classification for the ViT and 19.1% for PD classification and reduction in brain age prediction error by 1.26 years for CNNs, 2. Pre-training on large-scale video or synthetic MRI data boosted performance of ViTs, 3. CNNs were robust in limited-data settings, and in-domain pretraining enhanced their performances, 4. Pre-training improved generalization to out-of-distribution datasets and sites. Overall, we benchmarked different vision architectures, revealing the value of pre-training them with emerging datasets for model initialization. The resulting pre-trained models can be adapted to a range of downstream neuroimaging tasks, even when training data for the target task is limited.

Anzhe Cheng, Shukai Duan, Shixuan Li et al.

Mixture-of-Experts (MoE) architectures expand model capacity by sparsely activating experts but face two core challenges: misalignment between router logits and each expert's internal structure leads to unstable routing and expert underutilization, and load imbalances create straggler bottlenecks. Standard solutions, such as auxiliary load-balancing losses, can reduce load disparities but often weaken expert specialization and hurt downstream performance. To address these issues, we propose ERMoE, a sparse MoE transformer that reparameterizes each expert in a learned orthonormal eigenbasis and replaces learned gating logits with an "Eigenbasis Score", defined as the cosine similarity between input features and an expert's basis. This content-aware routing ties token assignments directly to experts' representation spaces, stabilizing utilization and promoting interpretable specialization without sacrificing sparsity. Crucially, ERMoE removes the need for explicit balancing losses and avoids the interfering gradients they introduce. We show that ERMoE achieves state-of-the-art accuracy on ImageNet classification and cross-modal image-text retrieval benchmarks (e.g., COCO, Flickr30K), while naturally producing flatter expert load distributions. Moreover, a 3D MRI variant (ERMoE-ba) improves brain age prediction accuracy by more than 7\% and yields anatomically interpretable expert specializations. ERMoE thus introduces a new architectural principle for sparse expert models that directly addresses routing instabilities and enables improved performance with scalable, interpretable specialization.