A Monosemantic Attribution Framework for Stable Interpretability in Clinical Neuroscience Transformer-Based Language Models

Abstract

Interpretability remains a key challenge for deploying language models (LM) in clinical settings such as progression diagnosis of Alzheimer disease, where early and trustworthy predictions are essential. Existing attribution methods exhibit high inter-method variability and unstable explanations due to the polysemantic nature of Transformer-Based LM and LLM representations, while mechanistic interpretability approaches lack direct alignment with model inputs and outputs and do not provide explicit importance scores. We introduce a unified interpretability framework that integrates attributional and mechanistic perspectives through monosemantic feature extraction. By constructing a monosemantic embedding space at the level of an transformer-based LM layer and optimizing the framework to explicitly reduce inter-method variability, our approach produces stable input-level importance scores and highlights salient features via a decompressed representation of the layer of interest, advancing the safe and trustworthy application of LMs in cognitive health and neurodegenerative disease.