Detecting Neurovascular Instability from Multimodal Physiological Signals Using Wearable-Compatible Edge AI: A Responsible Computational Framework

• URL: http://arxiv.org/abs/2603.20442v1
• Date: Fri, 20 Mar 2026 19:17:46 GMT
• Title: Detecting Neurovascular Instability from Multimodal Physiological Signals Using Wearable-Compatible Edge AI: A Responsible Computational Framework
• Abstract summary: We propose Melaguard, a multimodal ML framework for detecting neurovascular instability (NVI) from wearable-compatible physiological signals.<n>With 12.2 million incident strokes annually, continuous multimodal physiological monitoring offers a practical path to community-scale screening.
• Score: 0.0
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: We propose Melaguard, a multimodal ML framework (Transformer-lite, 1.2M parameters, 4-head self-attention) for detecting neurovascular instability (NVI) from wearable-compatible physiological signals prior to structural stroke pathology. The model fuses heart rate variability (HRV), peripheral perfusion index, SpO2, and bilateral phase coherence into a composite NVI Score, designed for edge inference (WCET <=4 ms on Cortex-M4). NVI - the pre-structural dysregulation of cerebrovascular autoregulation preceding overt stroke - remains undetectable by existing single-modality wearables. With 12.2 million incident strokes annually, continuous multimodal physiological monitoring offers a practical path to community-scale screening. Three-stage independent validation: (1) synthetic benchmark (n=10,000), AUC=0.88 [0.83-0.92]; (2) clinical cohort PhysioNet CVES (n=172; 84 stroke, 88 control) - Transformer-lite achieves AUC=0.755 [0.630-0.778], outperforming LSTM (0.643), Random Forest (0.665), SVM (0.472); HRV-SDNN discriminates stroke (p=0.011); (3) PPG pipeline PhysioNet BIDMC (n=53) -- pulse rate r=0.748 and HRV surrogate r=0.690 vs. ECG ground truth. Cross-modality validation on PPG-BP (n=219) confirms PPG morphology classifies cerebrovascular disease at AUC=0.923 [0.869-0.968]. Multimodal fusion consistently outperforms single-modality baselines. Code: https://github.com/ClevixLab/Melaguard

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