# CLEF: EEG Foundation Model for Learning Clinical Semantics

arXiv: https://arxiv.org/abs/2605.10817 · HTML: https://mlsanity.com/paper/2605.10817/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 19 of its 46 references that are in the map.
- First posted on arXiv 11 May 2026.

## Builds on (most cited first, 19 of 19)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [Taming Transformers for High-Resolution Image Synthesis](https://mlsanity.com/paper/2012.09841/) (2020)
- [Qwen2 Technical Report](https://mlsanity.com/paper/2407.10671/) (2024)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [Large Brain Model for Learning Generic Representations with Tremendous EEG Data in BCI](https://mlsanity.com/paper/2405.18765/) (2024)
- [Scaling Language-Image Pre-training via Masking](https://mlsanity.com/paper/2212.00794/) (2022)
- [CBraMod: A Criss-Cross Brain Foundation Model for EEG Decoding](https://mlsanity.com/paper/2412.07236/) (2024)
- [BENDR: using transformers and a contrastive self-supervised learning task to learn from massive amounts of EEG data](https://mlsanity.com/paper/2101.12037/) (2021)
- [NeuroLM: A Universal Multi-task Foundation Model for Bridging the Gap between Language and EEG Signals](https://mlsanity.com/paper/2409.00101/) (2024)
- [REVE: A Foundation Model for EEG -- Adapting to Any Setup with Large-Scale Pretraining on 25,000 Subjects](https://mlsanity.com/paper/2510.21585/) (2025)
- [Neuro-GPT: Towards A Foundation Model for EEG](https://mlsanity.com/paper/2311.03764/) (2023)
- [Open Vocabulary Electroencephalography-To-Text Decoding and Zero-shot Sentiment Classification](https://mlsanity.com/paper/2112.02690/) (2021)
- [MAEEG: Masked Auto-encoder for EEG Representation Learning](https://mlsanity.com/paper/2211.02625/) (2022)
- [CSBrain: A Cross-scale Spatiotemporal Brain Foundation Model for EEG Decoding](https://mlsanity.com/paper/2506.23075/) (2025)
- [EEGFormer: Towards Transferable and Interpretable Large-Scale EEG Foundation Model](https://mlsanity.com/paper/2401.10278/) (2024)
- [THD-BAR: Topology Hierarchical Derived Brain Autoregressive Modeling for EEG Generic Representations](https://mlsanity.com/paper/2511.13733/) (2025)

## Built on by (most cited first, 1 of 1)

- [BrainBench: Benchmarking Large Language Models for Comprehensive EEG Understanding](https://mlsanity.com/paper/2608.04156/) (2026)

## Abstract (arXiv)

Clinical EEG interpretation requires reasoning over full EEG sessions and integrating signal patterns with clinical context. Existing EEG foundation models are largely designed for short-window decoding and do not incorporate clinical context. We introduce CLEF, a clinically grounded long-context EEG foundation model. CLEF represents EEG sessions as 3D multitaper spectrogram tokens, enabling tractable Transformer modeling at session scale, and aligns embeddings with neurologist reports and structured EHR data through contrastive objectives. We evaluate CLEF on a new 234-task benchmark spanning disease phenotypes, medication exposures, and EEG findings, with more than 260k EEG sessions from over 108k patients. CLEF outperforms prior EEG foundation models on 229 of 234 tasks, improving mean AUROC from 0.65 to 0.74. Reconstruction-only pretraining surpasses prior EEG foundation models, while report and EHR alignment yields further gains. Held-out concept and external-cohort experiments suggest that these representations transfer beyond observed alignment targets. These results support session-scale, clinically grounded representation learning as a promising foundation-model paradigm for clinical EEG.