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However, cortex\u2013muscle interactions in either direction are rarely described, with reports limited predominantly to investigation of linear coupling, using corticomuscular coherence or Granger causality. Information-theoretic tools such as transfer entropy detect both linear and non-linear interactions between processes. This observational case\u2013control study applies transfer entropy to determine intra- and cross-frequency cortex\u2013muscle coupling in young people with dystonia\/dystonic cerebral palsy. Fifteen children with dystonia\/dystonic cerebral palsy and 13 controls, aged 12\u201318 years, performed a grasp task with their dominant hand. Mechanical perturbations were provided by an electromechanical tapper. Bipolar scalp EEG over contralateral sensorimotor cortex and surface EMG over first dorsal interosseous were recorded. Multi-scale wavelet transfer entropy was applied to decompose signals into functional frequency bands of oscillatory activity and to quantify intra- and cross-frequency coupling between brain and muscle. Statistical significance against the null hypothesis of zero transfer entropy was established, setting individual 95% confidence thresholds. The proportion of individuals in each group showing significant transfer entropy for each frequency combination\/direction was compared using Fisher's exact test, correcting for multiple comparisons. Intra-frequency transfer entropy was detected in all participants bidirectionally in the beta (16\u201332\u2005Hz) range and in most participants from EEG to EMG in the alpha (8\u201316\u2005Hz) range. Cross-frequency transfer entropy across multiple frequency bands was largely similar between groups, but a specific coupling from low-frequency EMG to beta EEG was significantly reduced in dystonia [P = 0.0061 (corrected)]. The demonstration of bidirectional cortex\u2013muscle communication in dystonia emphasizes the value of transfer entropy for exploring neural communications in neurological disorders. The novel finding of diminished coupling from low-frequency EMG to beta EEG in dystonia suggests impaired cortical feedback of proprioceptive information with a specific frequency signature that could be relevant to the origin of the excessive low-frequency drive to muscle.<\/jats:p>","DOI":"10.1093\/braincomms\/fcae061","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T22:16:10Z","timestamp":1708985770000},"source":"Crossref","is-referenced-by-count":9,"title":["Cross-frequency cortex\u2013muscle interactions are abnormal in young people with dystonia"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1726-4251","authenticated-orcid":false,"given":"Zhenghao","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Engineering, King's College London , London WC2R 2LS , UK"},{"name":"School of Biomedical Engineering, Dalian University of Technology , Dalian 116024 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Lin","sequence":"additional","affiliation":[{"name":"Children's Neuroscience, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust (GSTT) , London SE1 7EH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo","family":"Simeone","sequence":"additional","affiliation":[{"name":"Department of Engineering, King's College London , London WC2R 2LS , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry R","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London , London SE5 9RX , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran","family":"Cvetkovic","sequence":"additional","affiliation":[{"name":"Department of Engineering, King's College London , London WC2R 2LS , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verity M","family":"McClelland","sequence":"additional","affiliation":[{"name":"Children's Neuroscience, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust (GSTT) , London SE1 7EH , UK"},{"name":"Department of Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London , London SE5 9RX , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"issue":"7","key":"2024043010155953700_fcae061-B1","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1002\/mds.25475","article-title":"Phenomenology and classification of dystonia: A consensus update","volume":"28","author":"Albanese","year":"2013","journal-title":"Mov Disord"},{"issue":"7","key":"2024043010155953700_fcae061-B2","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1093\/brain\/awt150","article-title":"Secondary and primary dystonia: Pathophysiological differences","volume":"136","author":"Kojovic","year":"2013","journal-title":"Brain"},{"issue":"2","key":"2024043010155953700_fcae061-B3","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.nbd.2011.01.026","article-title":"The functional neuroanatomy of dystonia","volume":"42","author":"Neychev","year":"2011","journal-title":"Neurobiol Dis"},{"issue":"6","key":"2024043010155953700_fcae061-B4","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1093\/brain\/awz112","article-title":"Network localization of cervical dystonia based on causal brain lesions","volume":"142","author":"Corp","year":"2019","journal-title":"Brain"},{"issue":"2","key":"2024043010155953700_fcae061-B5","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.nbd.2010.08.025","article-title":"Neurophysiology of dystonia: The role of inhibition","volume":"42","author":"Hallett","year":"2011","journal-title":"Neurobiol Dis"},{"key":"2024043010155953700_fcae061-B6","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1007\/s00221-020-05863-2","article-title":"Delineating the electrophysiological signature of dystonia","volume":"238","author":"Latorre","year":"2020","journal-title":"Exp Brain Res"},{"key":"2024043010155953700_fcae061-B7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3389\/fneur.2018.00012","article-title":"How many types of dystonia? 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