4D Multimodal Co-attention Fusion Network with Latent Contrastive Alignment for Alzheimer's Diagnosis

Multimodal neuroimaging provides complementary structural and functional insights into both human brain organization and disease-related dynamics. Recent studies demonstrate enhanced diagnostic sensitivity for Alzheimer's disease (AD) through synergistic integration of neuroimaging data (e.g., sMRI, fMRI) with tabular data (e.g., behavioral and cognitive tests). However, the intrinsic heterogeneity across modalities (e.g., 4D spatiotemporal fMRI dynamics vs. 3D anatomical sMRI structure) presents critical challenges for discriminative feature fusion, often leading to information loss or biased fusion. To bridge this gap, we propose M2M-AlignNet: a multimodal co-attention network with latent alignment for early AD diagnosis using sMRI and fMRI. At the core of our approach is a multi-patch-to-multi-patch (M2M) contrastive loss function that quantifies and reduces representational discrepancies via weighted patch correspondence, explicitly aligning fMRI components across brain regions with their sMRI structural substrates without one-to-one constraints. Additionally, we propose a latent-as-query co-attention module to autonomously discover fusion patterns, circumventing modality prioritization biases while minimizing feature redundancy. We conduct extensive experiments to confirm the effectiveness of our method and highlight the correspondence between fMRI and sMRI as AD biomarkers.