Stroke Lesions as a Rosetta Stone for Language Model Interpretability
This provides a novel interpretability method for LLMs by leveraging clinical neuroscience, potentially benefiting researchers in AI and cognitive science, though it is incremental in applying existing lesion-symptom mapping to a new domain.
The study tackled the problem of validating which components of large language models (LLMs) are necessary for language function by using stroke lesion data as an external reference, finding that LLM error profiles predicted human lesion locations above chance in 67% of picture naming and 68.3% of sentence completion conditions.
Large language models (LLMs) have achieved remarkable capabilities, yet methods to verify which model components are truly necessary for language function remain limited. Current interpretability approaches rely on internal metrics and lack external validation. Here we present the Brain-LLM Unified Model (BLUM), a framework that leverages lesion-symptom mapping, the gold standard for establishing causal brain-behavior relationships for over a century, as an external reference structure for evaluating LLM perturbation effects. Using data from individuals with chronic post-stroke aphasia (N = 410), we trained symptom-to-lesion models that predict brain damage location from behavioral error profiles, applied systematic perturbations to transformer layers, administered identical clinical assessments to perturbed LLMs and human patients, and projected LLM error profiles into human lesion space. LLM error profiles were sufficiently similar to human error profiles that predicted lesions corresponded to actual lesions in error-matched humans above chance in 67% of picture naming conditions (p < 10^{-23}) and 68.3% of sentence completion conditions (p < 10^{-61}), with semantic-dominant errors mapping onto ventral-stream lesion patterns and phonemic-dominant errors onto dorsal-stream patterns. These findings open a new methodological avenue for LLM interpretability in which clinical neuroscience provides external validation, establishing human lesion-symptom mapping as a reference framework for evaluating artificial language systems and motivating direct investigation of whether behavioral alignment reflects shared computational principles.