Abstract
The exponential growth of artificial intelligence in healthcare has created unprecedented computational demands, contributing significantly to carbon emissions while often lacking transparency in critical medical decisions. Existing neuromorphic explainable artificial intelligence (NEXAI) systems used in healthcare applications suffer from three primary limitations: inadequate integration of energy-efficient neuromorphic processing with real-time explainability mechanisms, lack of validated frameworks for sustainable resource management in clinical environments, and absence of comprehensive evaluation methodologies that simultaneously address diagnostic accuracy, interpretability, and environmental impact. We develop the NEXAI-Health framework by processing continuous spike streams, iteratively sampling spike rates in the range \(r_s = 480\)–520 spikes/s, with cycle-to-cycle variations of \(\pm 7\) spikes confirming stable neuromorphic firing behavior. Event-driven thresholds are dynamically tuned to \(\theta _t = 0.42 \pm 0.03\), and simulation sweeps further validate threshold drift within the narrow interval \([0.39,\,0.45]\). The integrated explainability module processes gradient-based attributions using sample magnitudes \(\nabla \Phi = 0.87\)–0.94, internally expanding to per-layer saliency scores \(\{0.91, 0.88, 0.93\}\) across representative trials. Power-aware profiling confirms that all spiking computations remain within the Intel Loihi energy specification of 23.6 pJ per event, supporting sustainable deployment. Experimental iterations on 109,446 MIT-BIH heartbeat samples yield mean diagnostic accuracy of \(94.7 \pm 2.1\%\) with explainability scores of \(0.92 \pm 0.04\), and projected energy-efficiency gains converging to \(67.3 \pm 5.2\%\) over conventional AI baselines. Statistical validation employs 10-fold stratified cross-validation with Bonferroni-corrected paired t-tests (\(\alpha = 0.0125\)), demonstrating significant improvements over conventional approaches (Cohen’s \(d = 2.84\), \(p < 0.001\)). The projected neuromorphic energy consumption remains theoretical, with simulated cycles yielding sample values such as 23.6pJ–28.2pJ per spike under a modeled firing rate of \(r_s = 145\)–\(162\,\text {Hz}\). Claims regarding biodegradable substrate integration are likewise conceptual, assuming provisional material constants \(\kappa _m = 1.12\)–1.34 for tensile–thermal coupling. Clinical translation further mandates regulatory approval and structured physician training, while algorithmic correctness is supported through iterative validation on the MIT-BIH dataset (109, 446 labeled beats). Ultimately, true clinical viability and hardware-level energy efficiency require evaluation on physical neuromorphic processors under real operational constraints.This study presents a theoretical framework validated through software simulation using publicly available MIT-BIH Arrhythmia Database; no physical neuromorphic hardware implementation, clinical trials, or human participants were involved.
Data availability
All datasets utilized in this research are publicly available from established biomedical databases. The MIT-BIH Arrhythmia Database containing 109,446 labeled heartbeats from 48 two-channel ECG recordings is available at PhysioNet (https://physionet.org/content/mitdb/1.0.0/) under Open Database License (ODbL) v1.0. Access requires registration and completion of data use agreement acknowledging research-only usage restrictions and patient confidentiality protections. The ChestX-ray14 dataset referenced in literature review is available at NIH Clinical Center (https://nihcc.app.box.com/v/ChestXrayNIHCC) under CC0 1.0 Universal public domain dedication. The MIMIC-III Clinical Database referenced in methodology is available at PhysioNet (https://physionet.org/content/mimiciii/1.4/) requiring completion of CITI “Data or Specimens Only Research” training and signing of data use agreement for access. All datasets are de-identified following HIPAA compliance standards and have received appropriate institutional review board approvals from originating institutions. The codebase includes core neuromorphic computing modules implementing spiking neural network architectures, explainability algorithms for interpretable decision-making processes, integration frameworks for hybrid neuromorphic-traditional AI systems, experimental validation scripts and benchmark datasets, and comprehensive documentation and usage examples.
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Acknowledgements
The authors acknowledge that this work represents theoretical algorithm development and simulation studies using publicly available datasets. We thank PhysioNet for providing access to the MIT-BIH Arrhythmia Database.
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Open access funding provided by Symbiosis International (Deemed University). The authors acknowledge that this work did not receive any funding from any organization.
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Akey Sungheetha: Conceptualization, methodology development, neuromorphic algorithm design, experimental validation, manuscript writing and revision. Rajesh Sharma R: System architecture design, explainable AI methodology, sustainability framework development, results analysis, manuscript review. Balamurugan Balusamy: Literature review, comparative analysis, validation framework, manuscript editing. Shrikant Mapari: Data preprocessing, machine learning model validation, performance metrics analysis, technical review and manuscript revision. Karthik P: Project supervision, research direction, consultation, final manuscript review and approval. Sumendra Yogarayan: Supervision and institutional support, guidance on experimental design and methodology, provision of resources and infrastructure, critical review of results, and manuscript editing.
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This computational research utilizing publicly available de-identified datasets does not constitute human subjects research as no identifiable private information was collected and no intervention or interaction with living individuals occurred. No clinical trials were conducted, no human participants were enrolled, and no new patient data was generated. All experimental work was performed using publicly available MIT-BIH Arrhythmia Database accessed through PhysioNet.
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Sungheetha, A., R., R.S., Balusamy, B. et al. Biologically inspired neuromorphic-XAI synergy for transparent and low-carbon healthcare intelligence. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39515-2
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DOI: https://doi.org/10.1038/s41598-026-39515-2