A Dual-Modal Biosensing Approach to Evaluate Cortico-Muscular Coupling in Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis (AIS) is associated with central neural control and peripheral muscle abnormalities. However, dynamic cortico-muscular coupling (CMC) during fatigue remains poorly understood. We used synchronous 32-channel electroencephalography and 32-channel high-density electromyography (HD-EMG) to record data from 20 adolescents with AIS and 20 healthy controls during the Biering-Sørensen test. Wavelet coherence and topographic mapping were used to characterize CMC and its spatial distribution. Descriptive analyses indicated group- and fatigue-related patterns in HD-EMG activation, cortical connectivity, and CMC topographies. For the prespecified C3/C4 regional analyses, effect sizes, 95% confidence intervals, exact p values, and false-discovery-rate-adjusted p values are reported to support transparent interpretation. These multimodal observations provide exploratory physiological patterns that require confirmation in larger studies with prespecified primary outcomes.