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.