Decoupling Parcellation from Classification: Systematic Benchmark of Fast Brain Segmentation Methods for Alzheimer's Disease Detection

Abstract

Brain parcellation and classification are typically evaluated in isolation, yet downstream AD detection performance depends on their interaction. We decouple these components and systematically benchmark fast deep learning parcellation methods (SynthSeg+, OpenMAP-T1) against the FreeSurfer (FS-HV) clinical baseline through down- stream AD classification on OASIS-1. Our factorial design evaluates three parcellation methods, two volumetry strategies (hard vs. soft), and four classifier paradigms (clinical thresholds, supervised feedforward networks, ensemble methods, and foundation models with zero/few-shot prompting), with all results quantified using BCa Bootstrap 95% confidence intervals.