International Transfer of Stochastic Cortical Self-Reconstruction

Stochastic cortical self-reconstruction (SCSR) enables personalized mapping of gray matter atrophy, a hallmark of neurodegenerative disorders such as Alzheimer's disease (AD), onto high-resolution cortical surfaces. Unlike conventional normative modeling approaches, which typically operate at a coarse regional level and remain inherently constrained by the covariates included during training, SCSR estimates an individualized healthy reference directly from the observed cortical thickness at the vertex level. This allows the detection of subtle, subject-specific deviations from healthy cortical shape. In this work, we investigate the generalization and transferability of SCSR, originally trained on UK Biobank (UKB) data, to an independent Chinese population dataset. Specifically, we evaluate the ability of SCSR-derived Z-scores to discriminate between healthy scans, individuals with mild cognitive impairment (MCI), and patients with AD, while also assessing model robustness across the lifespan. We compare four training strategies: direct application of the UKB-trained model, fine-tuning on Chinese data, training from scratch, and joint training on UKB and Chinese cohorts. As reconstruction backbones, we consider both a multilayer perceptron (MLP) and a Spherical UNet (SUNet). Our results demonstrate that SCSR provides robust detection of cortical atrophy in the Chinese population across all evaluated models. The highest discriminative performance was achieved by the fine-tuned SUNet model (average pairwise AUC = 0.848), followed closely by the UKB-trained SUNet. Moreover, reconstruction errors remained low across the lifespan, even when the training population exhibited a substantially narrower age distribution, indicating strong cross-population transferability.