EVA-Net: Interpretable Anomaly Detection for Brain Health via Learning Continuous Aging Prototypes from One-Class EEG Cohorts

Abstract

The brain age is a key indicator of brain health. While electroencephalography (EEG) is a practical tool for this task, existing models struggle with the common challenge of imperfect medical data, such as learning a ``normal'' baseline from weakly supervised, healthy-only cohorts. This is a critical anomaly detection task for identifying disease, but standard models are often black boxes lacking an interpretable structure. We propose EVA-Net, a novel framework that recasts brain age as an interpretable anomaly detection problem. EVA-Net uses an efficient, sparsified-attention Transformer to model long EEG sequences. To handle noise and variability in imperfect data, it employs a Variational Information Bottleneck to learn a robust, compressed representation. For interpretability, this representation is aligned to a continuous prototype network that explicitly learns the normative healthy aging manifold. Trained on 1297 healthy subjects, EVA-Net achieves state-of-the-art accuracy. We validated its anomaly detection capabilities on an unseen cohort of 27 MCI and AD patients. This pathological group showed significantly higher brain-age gaps and a novel Prototype Alignment Error, confirming their deviation from the healthy manifold. EVA-Net provides an interpretable framework for healthcare intelligence using imperfect medical data.