Towards Brain MRI Foundation Models for the Clinic: Findings from the FOMO25 Challenge

Clinical deployment of automated brain MRI analysis faces a fundamental challenge: clinical data is heterogeneous and noisy, and high-quality labels are prohibitively costly to obtain. Self-supervised learning (SSL) can address this by leveraging the vast amounts of unlabeled data produced in clinical workflows to train robust \textit{foundation models} that adapt out-of-domain with minimal supervision. However, the development of foundation models for brain MRI has been limited by small pretraining datasets and in-domain benchmarking focused on high-quality, research-grade data. To address this gap, we organized the FOMO25 challenge as a satellite event at MICCAI 2025. FOMO25 provided participants with a large pretraining dataset, FOMO60K, and evaluated models on data sourced directly from clinical workflows in few-shot and out-of-domain settings. Tasks covered infarct classification, meningioma segmentation, and brain age regression, and considered both models trained on FOMO60K (method track) and any data (open track). Nineteen foundation models from sixteen teams were evaluated using a standardized containerized pipeline. Results show that (a) self-supervised pretraining improves generalization on clinical data under domain shift, with the strongest models trained \textit{out-of-domain} surpassing supervised baselines trained \textit{in-domain}. (b) No single pretraining objective benefits all tasks: MAE favors segmentation, hybrid reconstruction-contrastive objectives favor classification, and (c) strong performance was achieved by small pretrained models, and improvements from scaling model size and training duration did not yield reliable benefits.

Outcome-Grounded Advantage Reshaping for Fine-Grained Credit Assignment in Mathematical Reasoning

Group Relative Policy Optimization (GRPO) has emerged as a promising critic-free reinforcement learning paradigm for reasoning tasks. However, standard GRPO employs a coarse-grained credit assignment mechanism that propagates group-level rewards uniformly to to every token in a sequence, neglecting the varying contribution of individual reasoning steps. We address this limitation by introducing Outcome-grounded Advantage Reshaping (OAR), a fine-grained credit assignment mechanism that redistributes advantages based on how much each token influences the model's final answer. We instantiate OAR via two complementary strategies: (1) OAR-P, which estimates outcome sensitivity through counterfactual token perturbations, serving as a high-fidelity attribution signal; (2) OAR-G, which uses an input-gradient sensitivity proxy to approximate the influence signal with a single backward pass. These importance signals are integrated with a conservative Bi-Level advantage reshaping scheme that suppresses low-impact tokens and boosts pivotal ones while preserving the overall advantage mass. Empirical results on extensive mathematical reasoning benchmarks demonstrate that while OAR-P sets the performance upper bound, OAR-G achieves comparable gains with negligible computational overhead, both significantly outperforming a strong GRPO baseline, pushing the boundaries of critic-free LLM reasoning.

DecoFuse: Decomposing and Fusing the "What", "Where", and "How" for Brain-Inspired fMRI-to-Video Decoding

Decoding visual experiences from brain activity is a significant challenge. Existing fMRI-to-video methods often focus on semantic content while overlooking spatial and motion information. However, these aspects are all essential and are processed through distinct pathways in the brain. Motivated by this, we propose DecoFuse, a novel brain-inspired framework for decoding videos from fMRI signals. It first decomposes the video into three components - semantic, spatial, and motion - then decodes each component separately before fusing them to reconstruct the video. This approach not only simplifies the complex task of video decoding by decomposing it into manageable sub-tasks, but also establishes a clearer connection between learned representations and their biological counterpart, as supported by ablation studies. Further, our experiments show significant improvements over previous state-of-the-art methods, achieving 82.4% accuracy for semantic classification, 70.6% accuracy in spatial consistency, a 0.212 cosine similarity for motion prediction, and 21.9% 50-way accuracy for video generation. Additionally, neural encoding analyses for semantic and spatial information align with the two-streams hypothesis, further validating the distinct roles of the ventral and dorsal pathways. Overall, DecoFuse provides a strong and biologically plausible framework for fMRI-to-video decoding. Project page: https://chongjg.github.io/DecoFuse/.