# GCAN: Generative Counterfactual Attention-guided Network for Explainable Cognitive Decline Diagnostics based on fMRI Functional Connectivity

arXiv: https://arxiv.org/abs/2403.01758 · HTML: https://mlsanity.com/paper/2403.01758/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 9 of its 19 references that are in the map.
- First posted on arXiv 4 Mar 2024.

## Builds on (most cited first, 9 of 9)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [Inception-v4, Inception-ResNet and the Impact of Residual Connections on Learning](https://mlsanity.com/paper/1602.07261/) (2016)
- [Score-CAM: Score-Weighted Visual Explanations for Convolutional Neural Networks](https://mlsanity.com/paper/1910.01279/) (2019)
- [Community-Aware Transformer for Autism Prediction in fMRI Connectome](https://mlsanity.com/paper/2307.10181/) (2023)
- [Learn-Explain-Reinforce: Counterfactual Reasoning and Its Guidance to Reinforce an Alzheimer's Disease Diagnosis Model](https://mlsanity.com/paper/2108.09451/) (2021)
- [Brain Structure-Function Fusing Representation Learning using Adversarial Decomposed-VAE for Analyzing MCI](https://mlsanity.com/paper/2305.14404/) (2023)
- [Punctate White Matter Lesion Segmentation in Preterm Infants Powered by Counterfactually Generative Learning](https://mlsanity.com/paper/2309.03440/) (2023)

## Built on by (most cited first, 2 of 2)

- [A Survey on the Integration of Generative AI for Critical Thinking in Mobile Networks](https://mlsanity.com/paper/2404.06946/) (2024)
- [Discovering robust biomarkers of psychiatric disorders from resting-state functional MRI via graph neural networks: A systematic review](https://mlsanity.com/paper/2405.00577/) (2024)

## Abstract (arXiv)

Diagnosis of mild cognitive impairment (MCI) and subjective cognitive decline (SCD) from fMRI functional connectivity (FC) has gained popularity, but most FC-based diagnostic models are black boxes lacking casual reasoning so they contribute little to the knowledge about FC-based neural biomarkers of cognitive decline.To enhance the explainability of diagnostic models, we propose a generative counterfactual attention-guided network (GCAN), which introduces counterfactual reasoning to recognize cognitive decline-related brain regions and then uses these regions as attention maps to boost the prediction performance of diagnostic models. Furthermore, to tackle the difficulty in the generation of highly-structured and brain-atlas-constrained FC, which is essential in counterfactual reasoning, an Atlas-Aware Bidirectional Transformer (AABT) method is developed. AABT employs a bidirectional strategy to encode and decode the tokens from each network of brain atlas, thereby enhancing the generation of high-quality target label FC. In the experiments of hospital-collected and ADNI datasets, the generated attention maps closely resemble FC abnormalities in the literature on SCD and MCI. The diagnostic performance is also superior to baseline models. The code is available at https://github.com/SXR3015/GCAN