Current brain surface-based prediction models often overlook the variability of regional attributes at the cortical feature level. While graph neural networks (GNNs) excel at capturing regional differences, they encounter challenges when dealing with complex, high-density graph structures. In this work, we consider the cortical surface mesh as a sparse graph and propose an interpretable prediction model-Surface Graph Neural Network (SurfGNN). SurfGNN employs topology-sampling learning (TSL) and region-specific learning (RSL) structures to manage individual cortical features at both lower and higher scales of the surface mesh, effectively tackling the challenges posed by the overly abundant mesh nodes and addressing the issue of heterogeneity in cortical regions. Building on this, a novel score-weighted fusion (SWF) method is implemented to merge nodal representations associated with each cortical feature for prediction. We apply our model to a neonatal brain age prediction task using a dataset of harmonized MR images from 481 subjects (503 scans). SurfGNN outperforms all existing state-of-the-art methods, demonstrating an improvement of at least 9.0% and achieving a mean absolute error (MAE) of 0.827+0.056 in postmenstrual weeks. Furthermore, it generates feature-level activation maps, indicating its capability to identify robust regional variations in different morphometric contributions for prediction.

Major depressive disorder (MDD) is a complex psychiatric disorder that affects the lives of hundreds of millions of individuals around the globe. Even today, researchers debate if morphological alterations in the brain are linked to MDD, likely due to the heterogeneity of this disorder. The application of deep learning tools to neuroimaging data, capable of capturing complex non-linear patterns, has the potential to provide diagnostic and predictive biomarkers for MDD. However, previous attempts to demarcate MDD patients and healthy controls (HC) based on segmented cortical features via linear machine learning approaches have reported low accuracies. In this study, we used globally representative data from the ENIGMA-MDD working group containing an extensive sample of people with MDD (N=2,772) and HC (N=4,240), which allows a comprehensive analysis with generalizable results. Based on the hypothesis that integration of vertex-wise cortical features can improve classification performance, we evaluated the classification of a DenseNet and a Support Vector Machine (SVM), with the expectation that the former would outperform the latter. As we analyzed a multi-site sample, we additionally applied the ComBat harmonization tool to remove potential nuisance effects of site. We found that both classifiers exhibited close to chance performance (balanced accuracy DenseNet: 51%; SVM: 53%), when estimated on unseen sites. Slightly higher classification performance (balanced accuracy DenseNet: 58%; SVM: 55%) was found when the cross-validation folds contained subjects from all sites, indicating site effect. In conclusion, the integration of vertex-wise morphometric features and the use of the non-linear classifier did not lead to the differentiability between MDD and HC. Our results support the notion that MDD classification on this combination of features and classifiers is unfeasible.