arXiv · 2605.22774
CogAdapt: Adapting Clinical ECG Foundation Models for Wearable Cognitive Load Assessment
Abstract
Assessing cognitive load continuously and at low latency would help adaptive human-computer interaction, but it remains hard because labeled data are scarce and models generalize poorly across subjects. Recent ECG foundation models, pre-trained on millions of clinical diagnostic ECG recordings, yet they do not apply directly to wearable devices when the sensor configuration and the task both differ. We present CogAdapt, a framework that adapts a clinical ECG foundation model to wearable cognitive load assessment. CogAdapt has two parts. LeadBridge is a learnable adapter that maps 3-lead wearable signals to a 12-lead-compatible representation. ProFine is a progressive fine-tuning strategy that unfreezes encoder layers in stages while limiting representational drift in the pre-trained model. On two public datasets (CLARE and CL-Drive) under leave-one-subject-out cross-validation, CogAdapt reaches macro-F1 of 0.626 and 0.768, improving over from-scratch baselines by 11.2 and 16.1 percentage points. The results show that a clinical ECG pretraining can support subject-independent cognitive load assessment from wearable sensors.
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Amir Mousavi, Erfan Nourbakhsh, Mohammad Sadegh Sirjani, Mimi Xie, Rocky Slavin, Leslie Neely, John Davis, John Quarles. 2026-05-21. CogAdapt: Adapting Clinical ECG Foundation Models for Wearable Cognitive Load Assessment. https://arxiv.org/abs/2605.22774
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