# MedTS-TTT: Test-Time Training for Medical Time Series Classification

arXiv: https://arxiv.org/abs/2606.21329 · HTML: https://mlsanity.com/paper/2606.21329/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 26 references that are in the map.
- First posted on arXiv 19 Jun 2026.

## Builds on (most cited first, 12 of 12)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Informer: Beyond Efficient Transformer for Long Sequence Time-Series Forecasting](https://mlsanity.com/paper/2012.07436/) (2020)
- [A Time Series is Worth 64 Words: Long-term Forecasting with Transformers](https://mlsanity.com/paper/2211.14730/) (2022)
- [Autoformer: Decomposition Transformers with Auto-Correlation for Long-Term Series Forecasting](https://mlsanity.com/paper/2106.13008/) (2021)
- [FEDformer: Frequency Enhanced Decomposed Transformer for Long-term Series Forecasting](https://mlsanity.com/paper/2201.12740/) (2022)
- [iTransformer: Inverted Transformers Are Effective for Time Series Forecasting](https://mlsanity.com/paper/2310.06625/) (2023)
- [Learning to (Learn at Test Time): RNNs with Expressive Hidden States](https://mlsanity.com/paper/2407.04620/) (2024)
- [Test-Time Training with Masked Autoencoders](https://mlsanity.com/paper/2209.07522/) (2022)
- [Medformer: A Multi-Granularity Patching Transformer for Medical Time-Series Classification](https://mlsanity.com/paper/2405.19363/) (2024)
- [ViT3: Unlocking Test-Time Training in Vision](https://mlsanity.com/paper/2512.01643/) (2025)
- [MedGNN: Towards Multi-resolution Spatiotemporal Graph Learning for Medical Time Series Classification](https://mlsanity.com/paper/2502.04515/) (2025)
- [Personalized Sleep Staging Leveraging Source-free Unsupervised Domain Adaptation](https://mlsanity.com/paper/2412.12159/) (2024)

## Abstract (arXiv)

Medical time series (MedTS) signals such as electroencephalography (EEG) and electrocardiography (ECG) support many clinical applications. However, substantial subject-level heterogeneity often induces subject-level distribution shift, causing a fixed parameter set to generalize poorly to unseen individuals. Compared with domain adaptation methods that often depend on extra adaptation components or target-batch statistics, Test-Time Training (TTT) provides a more practical solution for sequential clinical data by enabling online adaptation from unlabeled test samples. However, many representative TTT methods require iterative inner-loop optimization, increasing test-time overhead. In this paper, we propose MedTS-TTT, a test-time training framework for medical time series modeling. MedTS-TTT is built upon Closed-Loop Self-Alignment Test-Time Training (CLSA-TTT) and a Gated Convolutional Backbone (GCB). CLSA-TTT constructs a token-level self-supervised target and performs a single-step fast-weight update for intra-layer closed-loop alignment, enabling rapid sample-wise adaptation without iterative inner-loop optimization. GCB combines CLSA-TTT-based fast adaptation and token-level fusion with a gated convolutional branch to balance local dynamic modeling and information-flow control. On 4 public datasets (2 EEG and 2 ECG) with subject-independent splits, MedTS-TTT achieves 11 top-1 rankings out of 12 evaluations across 9 baselines and 3 metrics. The code is publicly available at https://github.com/mingzhi-c/MedTS-TTT.