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01.
arXiv (CS.CL) 2026-06-16

Know Your Limits : On the Faithfulness of LLMs as Solvers and Autoformalizers in Legal Reasoning

Large Language Models (LLMs) achieve strong performance on reasoning tasks, but whether this reflects faithful logical inference or heuristic approximation remains unclear. We study this question in legal entailment by comparing three paradigms, including pure LLM classification, LLM-based Formal Reasoning, and solver-based Formal Reasoning using the Z3 SMT solver, on a re-annotated subset of ContractNLI across five LLMs. Our re-annotation reveals a systematic and measurable gap between pragmatic legal interpretation and strict formal entailment, where a substantial proportion of legally sound inferences are not formally grounded without additional unstated assumptions. While introducing formal structure improves accuracy, with LLM-based Formal Reasoning achieving the highest benchmark performance, we show that this gain does not imply faithful reasoning. We identify three recurring failure modes: scope laundering, where LLMs report solver-inconsistent classifications without executing the underlying formal reasoning, producing conclusions that appear logically grounded but are not; implicit constraint blindness, where LLMs overlook logical constraints present in formal representations; and program synthesis failures, where LLMs generate incorrect Z3 code despite structured prompting. Critically, scope laundering persists across all models, raising serious concerns about the faithfulness of LLM-based formal reasoning as a proxy for symbolic execution. These results reveal a fundamental gap between benchmark accuracy and logical faithfulness.

02.
arXiv (quant-ph) 2026-06-16

Nonlinear cascaded quantum network with giant emitters

arXiv:2404.09829v2 Announce Type: replace Abstract: Chiral quantum optics is central to developing scalable quantum networks, yet existing approaches rely predominantly on linear single-photon regimes. It remains unclear how to generate directional multiphotons. Here we show that giant emitters coupled to nonlinear quantum optical baths enable tunable directional correlated photons, revealing a mechanism for multiphoton directional emission. We demonstrate that the propagation phases of correlated photons, together with the coupling phases of giant emitters, can generate destructive interference in one direction while enhancing emission in the opposite direction, making directionality fully tunable. Building on this mechanism, we introduce a nonlinear cascaded quantum network paradigm mediated by correlated flying qubits, providing a configurable building block enabling distinct many-body applications beyond linear unidirectional setups. These results reveal a rich landscape for engineering multiphoton propagation and correlations through interference in giant emitter-nonlinear bath architectures, offering pathways for quantum networks and strongly correlated light-matter platforms.

03.
arXiv (CS.CL) 2026-06-11

Language Shapes Mental Health Evaluations in Large Language Models

Multilingual large language models (LLMs) are increasingly used in socially sensitive mental health contexts, including support chatbots, screening, and content moderation. This raises a reliability question: do semantically equivalent mental health inputs elicit comparable evaluations across languages, or systematic shifts consistent with language-associated social and cultural contexts? We examine this question in an English-Chinese setting with GPT-4o and Qwen3-32B using a two-level framework: construct-level evaluative orientation, measured by psychometric stigma instruments, and decision-level behavior, measured by binary stigma detection and four-class depression severity classification. Across instruments and models, Chinese prompts elicit higher stigma-related scores than English prompts. At the decision level, Chinese prompts reduce sensitivity to stigmatizing content and produce more conservative depression severity judgments, leading to more under-estimation errors. These findings show that prompt language can shift both evaluative orientation and downstream behavior in LLM-based mental health evaluation. They highlight the need to evaluate multilingual LLMs not only for aggregate performance, but also for whether they apply comparable evaluative standards across languages in socially sensitive domains.

04.
arXiv (CS.CV) 2026-06-11

Real-Time Neural Hair Denoising

We propose a lightweight real-time method for reconstructing strand-based hair G-Buffers from severely undersampled rasterized inputs. Our pipeline first applies neural spatial reconstruction and temporal accumulation to recover hair coverage, i.e., fractional hair visibility within a pixel, and tangent. It then uses a tangent-guided reconstruction step to complete the position, which is subsequently used for physically based deferred hair shading. We evaluate our method across a diverse set of hairstyles, including straight, wavy, afro, and ponytail styles, under both static and dynamic scenarios. Our method achieves higher hair reconstruction quality than existing hair-specific denoising techniques and general industrial neural reconstruction solutions such as DLSS and FSR.

06.
arXiv (CS.LG) 2026-06-12

The Range Shrinks, the Threat Remains: Re-evaluating LLM Package Hallucinations on the 2026 Frontier-Model Cohort

arXiv:2605.17062v2 Announce Type: replace-cross Abstract: Spracklen et al. (USENIX Security '25) showed that code-generating large language models hallucinate package names that do not exist on PyPI or npm at rates ranging from 5.2% on commercial models to 21.7% on open-source models, creating an attack surface for slopsquatting – the registration of malicious packages under hallucinated names. We replicate their methodology on five frontier code-capable LLMs released between October 2025 and March 2026: Claude Sonnet 4.6, Claude Haiku 4.5, GPT-5.4-mini, Gemini 2.5 Pro, and DeepSeek V3.2. Across 199,845 paired Python and JavaScript prompts validated against PyPI and npm master lists, we measure overall hallucination rates between 4.62% (Claude Haiku 4.5) and 6.10% (GPT-5.4-mini) – an order-of-magnitude compression of the inter-model spread observed by Spracklen, but not a retirement of the threat. Beyond replication, we identify a set of 127 package names (109 on PyPI, 18 on npm) that all five evaluated models invent identically; following coordinated disclosure with PyPI Security and Socket.dev, 53 of these (41 on PyPI, 12 on npm) remain registrable by an attacker after each registry's existing defenses, constituting a model-agnostic supply-chain attack surface that no single-model study can reveal. We further document a Python-over-JavaScript hallucination asymmetry that inverts Spracklen's 2024 finding, identify a Haiku-below-Sonnet inversion within the Anthropic family, and observe a Jaccard-similarity peak between DeepSeek V3.2 and GPT-5.4-mini (J = 0.343) suggestive of shared training-data origins.

07.
arXiv (CS.CL) 2026-06-15

MineExplorer: Evaluating Open-World Exploration of MLLM Agents in Minecraft

Multimodal large language models (MLLMs) have shown strong capabilities in perception, reasoning, and action generation. However, their ability to sustain exploration in dynamic open worlds remains unclear. Existing embodied and game-based benchmarks often compress interaction into short-horizon tasks or entangle success with domain-specific game mechanics. In this paper, we introduce MineExplorer benchmark for evaluating open-world exploration capabilities of MLLM agents in Minecraft. We first filter atomic tasks whose solutions rely heavily on Minecraft-specific knowledge to better reflect general open-world reasoning. Then we organize the benchmark around a ReAct-style capability formulation and compose atomic tasks into implicit multi-hop tasks. To further construct reliable instances, MineExplorer uses a multi-agent synthesis workflow that jointly designs task graphs, sandbox scenes, and rule-based milestone evaluators. Human evaluation shows that the multi-agent synthesis workflow produces significantly more reliable instances than a single-agent baseline. Experiments with advanced MLLM agents show that open-world exploration remains challenging, as strong models can handle many single-hop tasks but degrade sharply when hidden prerequisites must be coordinated over longer trajectories. Further analysis finds that task difficulty tracks agent completion, and larger models or thinking modes do not consistently translate into better performance. Code and dataset are available at https://github.com/Jometeorie/MineExplorer.

08.
Nature Medicine 2026-06-10

Brain Health for Economic Resilience: a data-driven framework for the brain-positive economic transition

Announced in this Comment and in collaboration with Nature Medicine is the convening of the Brain Health for Economic Resilience Commission, a global, transdisciplinary effort to define, measure and operationalize brain health and cognitive capacity as foundational drivers of economic resilience.

09.
arXiv (CS.LG) 2026-06-16

A Gradient Perspective on RLVR Stability and Winner Advantage Policy Optimization

arXiv:2606.16154v1 Announce Type: new Abstract: Reinforcement learning with verifiable rewards (RLVR) improves language-model reasoning, but GRPO-style optimization remains prone to collapse. We analyse this instability through token-level gradient dynamics, deriving a taxonomy that predicts how updates affect next-token probabilities and entropy. The taxonomy shows that stability depends jointly on the advantage sign and token distribution under the current policy. Motivated by this finding, we propose Winner Advantage Policy Optimization (WAPO), a simple online clipped policy-gradient objective that updates only on positive-advantage completions. Across mathematical reasoning and multi-hop QA benchmarks, WAPO improves training stability and matches or outperforms baselines across multiple model families. Full code can be found at https://github.com/layer6ai-labs/wapo.

10.
arXiv (CS.LG) 2026-06-18

Do Time Series Foundation Model Benchmarks Hide Regime-Dependent Failures? Evidence from Traffic Speed Forecasting

arXiv:2606.18367v1 Announce Type: new Abstract: Standard benchmarks evaluate time series foundation models (TSFMs) using aggregate metrics, but these can mask severe failures in critical operating regimes. We introduce regime-stratified evaluation and apply it to three TSFMs on two standard traffic speed benchmarks. Traffic exhibits abrupt regime switching between free-flow and congested states, producing bimodal speed distributions during transitions. When we stratify by traffic regime, both accuracy and prediction-interval coverage degrade sharply during transitions: transition-regime MAE reaches 11 mph (versus 3 mph overall), and empirical coverage of 90% prediction intervals drops as low as 55%. These failures are invisible in aggregate metrics because free-flow observations dominate the sample. A simple historical conditional baseline (sampling from per-sensor training distributions) achieves better transition coverage than any TSFM, but has far worse overall accuracy. We propose bimodal mixture augmentation (BMA), a post-hoc method that combines TSFM forecasts with historical distributional knowledge, approaching the historical baseline's transition coverage while preserving the TSFM's accuracy. Our results suggest that TSFM benchmarks should incorporate regime-aware evaluation to surface failures that aggregate metrics hide.

12.
arXiv (CS.CV) 2026-06-12

VLADriveBench: Evaluating CoT-Action Relationship in VLA for Autonomous Driving

Vision-language-action (VLA) models generate chain-of-thought (CoT) reasoning alongside driving trajectories, but existing benchmarks evaluate only trajectory quality and do not assess whether the CoT is relevant, consistent, or causally connected to the driving action. We introduce VLADriveBench, a framework that combines observational metrics (mentioning, hallucination, contradiction, action alignment) with a CoT intervention protocol to provide complementary views of the CoT-action relationship. Applying VLADriveBench to three models across two architectures, we find that the two analyses can diverge sharply: ORION scores highest on observational alignment yet its CoT is epiphenomenal, while Alpamayo v1.5 scores lower yet its CoT is strongly causal, with visual salience gating the extent of CoT influence.

13.
arXiv (CS.AI) 2026-06-19

Tri-Info: Generalizable, Interpretable Failure Prediction for VLA Models via Information Theory

arXiv:2606.19998v1 Announce Type: cross Abstract: Vision-Language-Action (VLA) models are increasingly deployed across diverse tasks, yet they remain black boxes whose physical interactions can cause irreversible harm, making generalizable and interpretable failure detection essential. We observe that successful and failed rollouts carry systematically different information-theoretic signatures. Building on this, we formalize VLA control as a closed-loop information pipeline and derive the Triple Information-theoretic (Tri-Info) signals that capture whether actions remain diverse, temporally consistent, and coupled to state transitions. Across six VLA models and three benchmark environments, Tri-Info matches the strongest baselines in-domain. Moreover, Tri-Info transfers across architectures, environments, and the sim-to-real gap without retraining, reaching 83\% accuracy on real-world tasks where prior detectors collapse to chance. This establishes Tri-Info as a simple yet powerful method that not only detects failures with strong cross-domain generalization, but also delivers interpretable diagnostics of the underlying failure modes.

14.
arXiv (CS.AI) 2026-06-11

Forecasting Future Behavior as a Learning Task

arXiv:2606.11445v1 Announce Type: new Abstract: Trust in an AI system is often anchored by explanations of how it works, which one then uses to forecast its behavior on new inputs. For large reasoning models (LRMs), this conventional route is particularly difficult to follow: explanation methods for single token generations do not naturally generalize to long trajectories, and the trajectories themselves are often not faithful when read as natural language. We propose an alternative that bypasses the explanation step: treat behavior forecasting as a learnable task and train Behavior Forecasters that operates on a single reasoning trajectory to make the same forecasts one would typically seek from an explanation. The forecaster's training data is obtained by querying the LRM with no human annotation, and its inference is done in a single forward pass. We instantiate this approach on two tasks: how likely the LRM is to repeat its answer on re-runs, and how removing parts of the input changes its answer. We evaluate this approach on both tasks across three diverse reasoning datasets and find that trained Behavior Forecasters are more accurate than GPT-5.4 and Claude Opus-4.6 reading the same trajectories as naive readers, at a small fraction of their inference cost. We find that fine-tuning the backbone end-to-end and initializing it from the target LRM are each necessary for strong performance. These results show that the reasoning trajectory carries information about the LRM's future behavior that goes beyond what naive reading conveys.

15.
arXiv (CS.CL) 2026-06-12

Rigel: Reverse-Engineering the Metal 4.1 Tensor Compute Path on the Apple M4 Max GPU

Apple's Metal 4.1 exposes a tensor compute path: the Metal Performance Primitives (MPP) matmul2d operation over cooperative_tensor fragments, whose interface is documented but whose hardware behavior is deliberately hidden. The specification states which data-type rows are supported, never whether they are hardware-accelerated, where the operation physically executes, what its accumulator width is, or how it partitions matrix fragments across threads. We present Rigel, an empirical characterization of this path on a single Apple M4 Max (a pre-neural-accelerator generation). Using a checksum-gated, provenance-tracked microbenchmark harness, Rigel recovers eleven facts the v4.1 specification hides or contradicts. The headline finding: the Metal 4.1 fp8 (E4M3) matmul2d is emulated, not accelerated: it sustains 0.94x the throughput of fp16 despite reading half the operand bytes, so on M4 it is a memory-footprint feature, not a performance feature. We further show, via a three-signal triangulation (throughput ceiling, comparison against simdgroup_matrix, and per-rail power attribution), that matmul2d executes entirely on the GPU shader cores with no dedicated matrix datapath and no evidence of Apple Neural Engine routing; that it accumulates in >=fp32; and we reconstruct the opaque 8x8 cooperative_tensor fragment layout Apple documents nowhere. Acting on the characterization, a hand-fused GEMM + bias + GELU kernel beats the decomposed path by +6.5-12.9% in the cache-resident regime. All findings are reproducible from committed MIT-licensed code and per-cell CSVs.

16.
arXiv (CS.LG) 2026-06-12

Universal Time Series Generation with Neural Controlled Differential Equations

arXiv:2605.28507v2 Announce Type: replace Abstract: Recent work on the sequence universality of State Space Models (SSMs) has introduced efficient, maximally expressive continuous-time approaches for time-series modelling. While these works focus on discriminative settings, we extend this perspective to generative time-series modelling by proving that maximally expressive Structured Linear Controlled Differential Equations (SLiCEs) are universal time-series generators, in the sense that they can approximate the induced path laws of continuous causal pushforwards on compact latent sets in $W_\infty$. Building on these theoretical results, we propose Generative SLiCEs (G-SLiCEs), a maximally expressive continuous-time model for flow matching on path-space. Empirically, we show that expressivity improves performance in probabilistic forecasting and downstream tasks, while retaining the advantages of continuous-time models such as generalising to arbitrary observation grids. This is particularly beneficial for irregular grids, where fixed-grid models often struggle.

17.
arXiv (CS.CL) 2026-06-16

ChildGuard: A Specialized Dataset for Combatting Child-Targeted Hate Speech

Mental health industry faces growing concerns regarding hate speech directed at children's on social media, as exposure to such content can contribute to adverse psychological outcomes during critical stages of development. Current hate speech datasets and detection systems provide limited support for child-focused applications because they are primarily designed for adults and lack dedicated representations of age-specific characteristics associated with hate speech directed at children's. To address this gap, we introduce ChildGuard, a large-scale English dataset for child-targeted hate speech containing 351,877 annotated instances collected from X (formerly Twitter), Reddit, and YouTube. The dataset covers three age groups such as younger children's (under 11), pre-teens (11-12), and teens (13-17). ChildGuard contains two subsets such as a contextual subset (157K) and a lexical subset (194K). Evaluation using recent transformer-based models and LLMs achieves a best Macro-F1 of 82.07%, decreasing to 79.41%, 79.24%, 76.04%, and 74.88% on younger children's, contextual, implicit hate, and cross-subset settings, respectively.

18.
arXiv (CS.CV) 2026-06-12

Stereo Vision-Based Fall Prediction and Detection using Human Pose Estimation on the AMD Kria K26 SOM

Background and Objective: Falls among elderly people can cause serious injury and reduce quality of life. Timely prediction and detection are essential to prevent harm and support well-being. We propose a portable, low-power, battery-operated, vision-based fall prediction and detection system using HPE on an AMD Kria K26 System-on-Module (SOM). The objective is a non-intrusive, privacy-preserving system for real-time fall detection. Methods: The system uses an Intel RealSense D455 range-sensing camera connected to the K26 SOM by USB. It captures synchronized RGB and depth frames, 640 x 480 x 3 and 640 x 480 pixels, at 60 FPS. The SOM runs a three-stage pipeline with quantized YOLOX, Anchor-to-Joint (A2J), and fall-detection models. YOLOX identifies human bounding boxes from RGB frames, then discards the RGB frames to preserve privacy. A2J uses depth frames to estimate 15 joint keypoints per person. A CNN uses selected joint coordinates (x, y, z) to classify fall activity. YOLOX was trained on CrowdHuman; A2J on ITOP, MP-3DHP, UR Fall Detection, and a custom SDSU PSG dataset; and the CNN on UR Fall Detection and SDSU PSG. The design used a single-core DPU with a serial pipeline and a dual-core DPU running YOLOX and A2J with multiple threads. Results: Quantized accuracy was evaluated using IoU >= 50% for YOLOX, mAP with a 10-cm rule for A2J, and classification accuracy, (TP + TN)/(TP + TN + FP + FN), for the CNN. Accuracies were 74%, 84.13%, and 75.85%. Throughput improved from 2.5 FPS for the single-threaded pipeline to 4.5 FPS for the multi-threaded version. Conclusion: Results demonstrate the feasibility of privacy-preserving fall detection on an AMD Kria K26 edge device. On-device HPE and fall classification runs without cloud dependency, supporting elderly monitoring and assistive healthcare. Future work will improve model accuracy and speed.

19.
arXiv (CS.CL) 2026-06-11

To Intervene or Not: Guiding Inference-time Alignment with Probabilistic Model Blending

The wide deployment of LLMs has made model alignment necessary to make newly trained models safely and effectively respond to user instructions. Among different methods, inference-time alignment is often cheaper as it intervenes (i.e., offers guidances) only during output generation. Existing proposals apply guidances extracted from certain aligned models without properly assessing their reliability. Nonetheless, our systematic evaluation reveals that guidance effectiveness varies drastically across models; since ineffective guidances lead to further confusion and thus further interventions, the resulting excessive interventions typically indicate poor performance. To make interventions more effective and thus more efficient, we introduce BlendIn, an inference-time alignment framework that shifts from binary decisions to creating hybrid distributions integrating both models' knowledge. BlendIn stabilizes inference-time alignment by performing quality-aware alignment and proportionally weighting each model's contribution based on reliability. Compared with existing works, it preserves beneficial guidance while downweighting unreliable suggestions. BlendIn provides both diagnostic signals and mitigation strategies for misaligned guidance, achieving consistent and up to 50% performance improvement on challenging model pairs. Our code is available at: https://github.com/DecayingSeart/BlendIn.

20.
arXiv (CS.AI) 2026-06-16

AI Contagion in Social Networks

arXiv:2606.15206v1 Announce Type: cross Abstract: We study how artificial intelligence (AI) interacts with social communication networks to shape the stability of collective knowledge. Agents exchange information through a network while receiving AI-generated content, and AI systems retrain on the aggregate social information they influence. This interaction generates two feedback forces: an AI contagion channel, through which distortions diffuse across the network, and an AI social distortion multiplier, through which retraining amplifies past errors. Despite the high dimensionality of the environment, we show that the long-run behavior of the system admits a two-dimensional representation whose spectral radius determines whether AI-mediated information systems are dynamically stable or unstable. We characterize a sharp regulatory frontier identifying the minimum filtering required for stability and show how network topology shapes systemic informational risk.

21.
arXiv (CS.AI) 2026-06-19

Human-AI Agent Interaction in a Business Context

arXiv:2606.18716v1 Announce Type: cross Abstract: As AI agents are increasingly integrated into core business processes, understanding and designing effective interaction patterns between humans and AI agents becomes crucial for value creation. This study identifies and evaluates principles and criteria for a positive User Experience (UX) with AI agents, along with methods for its measurement. We identify user expectations and needs to facilitate adoption, build trust, and support user-centered decision-making by development teams. Using a mixed-methods approach that combines qualitative and quantitative techniques, we explore interaction patterns between humans and AI agents. The findings from this exploratory research serve as the basis to develop a survey experiment which evaluates the effectiveness of specific design elements on a larger scale. This foundational research contributes to the development of more intuitive and effective human-AI agent interactions in business settings.

22.
arXiv (CS.LG) 2026-06-11

JGRA: Jacobian Geometry Robustness Assessment in NISQ Noise-Aware Quantum Neural Networks

arXiv:2606.09964v2 Announce Type: replace-cross Abstract: The NISQ era places stringent constraints on quantum computation, where noise and decoherence fundamentally limit performance. In classical deep learning, model robustness and resilience to perturbations are well studied: deep neural networks (DNNs) maintain high performance despite pruning, noise injection, and structural perturbations due to inherent redundancy in their representations. A central challenge in quantum machine learning is to transfer this notion of robustness to quantum neural networks (QNNs) under realistic NISQ noise. While classical deep learning exhibits robustness through structural redundancy, analogous principles for QNNs remain underdeveloped. We propose JGRA: a framework for assessing robustness in noise-aware QNNs via Jacobian geometry, capturing model sensitivity to parameter perturbations induced by noise. Our method includes entropy-matched noise calibration, noise-aware training, and noise-conditioned Jacobian extraction, yielding geometric descriptors that link clean-regime structure to noisy inference behaviour. We also empirically demonstrate that these descriptors encode predictive information about robustness under unseen noise.

23.
arXiv (CS.AI) 2026-06-12

Can I Buy Your KV Cache?

arXiv:2606.13361v1 Announce Type: new Abstract: Right now, across the world, AI agents are repeating the same absurd act: to read one document, they each recompute it from scratch. Every agent re-runs prefill, the most compute-intensive step a large model takes, over identical text, only to rebuild a key-value (KV) cache identical to the one the agent before it just built. The same answer, computed a million times. We make a proposal that is almost offensively simple: compute it once. Let a publisher precompute a document's KV cache, and let every other agent buy the right to load it and skip prefill. It works, and it is token-exact: loading a precomputed KV and continuing matches prefilling from scratch (24/24 greedy tokens, and at the logits level), with no accuracy cost. On Qwen3-4B, reuse is 9-50x cheaper in compute than prefill, and the gap widens with length (prefill's attention scales with L^2), so a single reuse already pays it back. Then the part that matters: where the KV lives. Shipping it fails, because KV is nearly incompressible, so per-load egress costs more than the prefill it saves. Hosting it provider-side, exactly as production prompt-caching works, removes egress entirely. The size of the prize is set by our measured compute saving: serving one hot 3774-token document to 80M agents costs ~$1.5M to re-prefill but only ~$0.03M of reuse compute (49.7x less). The 0.1x cache-read tariff APIs charge passes a 10x discount to users while sitting inside this measured envelope, so the 10x is a floor that the measured ~50x compute saving clears, and the gap to the physical ~50x is provider margin: millions of dollars per popular document. We frame the resulting agent-native prefill CDN and leave lossless KV compression and a cross-party payment layer as the open problems.

24.
medRxiv (Medicine) 2026-06-15

Supporting people to access social security payments through the Special Rules for End of Life: a qualitative study of the perspectives of patients, carers and health care professionals

Background: People living with terminal illness face a double financial burden from additional costs and loss of earning for themselves and their carers. Social security benefits are intended to help alleviate some of this financial pressure, and in the UK and other countries people are eligible for fast-tracked access to financial support via the Special Rules for End of Life. One in 3 people who are eligible miss out on this support, yet there is limited evidence on the reasons for this take-up deficit. Objectives: The aim of this study is to understand the barriers and facilitators to claiming benefits for terminally ill people from the perspectives of patients, carers, and health care professionals. Methods: This is a qualitative study combining i) focus groups with healthcare professionals recruited via professional networks and social media, and ii) interviews with patients and carers recruited in hospital and hospice settings. We analysed the data using Practical Thematic Analysis Results: Fifty-five multidisciplinary healthcare professionals participated in 11 focus groups, and we interviewed 10 patients and carers. We constructed five descriptive themes to summarise the data: Navigating priorities and uncertainty; positive impacts alongside a sense of shame and stigma; talking about money, difficulties and dividends; everybodys, yet nobodys, responsibility; and sticking points in the system. Conclusion: The themes reveal several challenges that may contribute to people not taking up this financial support. However, discussions about access to benefits were also seen as a core part of holistic care, a positive way to offer support and a gateway to other discussions about end-of-life care preferences and decisions. Recommendations for policy and practice include evaluating the adoption of a diagnostic rather than a prognostic eligibility criteria, integrating discussions about benefits into existing processes such as advance care planning, and improving education and support for clinicians.

25.
medRxiv (Medicine) 2026-06-10

Towards the Virtual Amyotrophic Lateral Sclerosis Patient: Inferring Cortical Excitability through Whole-Brain Dynamical Modeling

Amyotrophic lateral sclerosis (ALS) is increasingly recognized as a multisystem neurodegenerative disorder in which motor-neuron degeneration is accompanied by widespread alterations in cortical dynamics. Among its most reproducible neurophysiological signatures is cortical hyperexcitability, yet how this local excitability imbalance shapes distributed whole-brain activity remains poorly understood. Here, we combined source-reconstructed resting-state MEG data, tractography-informed whole-brain modeling, and simulation-based inference to investigate whether ALS-related alterations in large-scale brain dynamics can be mechanistically explained by changes in cortical excitability. First, we characterized empirical brain dynamics using complementary features spanning regional activity amplitude and variability, functional connectivity, and avalanche-based metrics. These analyses revealed significant alterations in ALS patients relative to healthy controls, as well as associations with clinical impairment and disease staging. To mechanistically interpret these changes, we employed a reduced Wong-Wang whole-brain model in which local recurrent excitation modulates emergent large-scale neural dynamics. Simulations showed that increasing excitability systematically reproduced the empirical dynamical signatures observed in ALS. We then applied a simulation-based inference framework to estimate latent excitability parameters directly from empirical observations. Whole-brain model inversion revealed increased excitability in ALS patients compared with controls. The recovered excitability parameter was associated with disease staging, supporting its clinical relevance as a model-derived descriptor of ALS progression. Finally, by extending the model to estimate frontal and non-frontal excitability separately, we found that ALS-related alterations were predominantly associated with increased frontal excitability, whereas non-frontal regions appeared comparatively less affected. The recovered parameters related to disease staging. Together, these findings provide a mechanistic framework linking altered large-scale brain dynamics in ALS to selective cortical hyperexcitability, explaining how local excitability changes can give rise to global network reorganization. More broadly, they show how computational model inversion can recover latent multiscale pathophysiological processes from empirical neural recordings, offering a non-perturbative alternative to complex experimental paradigms typically required to causally probe local-to-global mechanisms.