Harmonizing Minds–Exploring Music’s Impact on Brain Health

• Music engages extensive neural networks in the brain, influencing memory, emotion, attention, and movement
• Music therapy and music medicine are the two primary forms of therapeutic music-based interventions
• Music-based interventions have shown promising potential in clinical settings, reducing anxiety, pain, and delirium in intensive care units; improving mood and reducing distress during chemotherapy; and improving symptoms in patients with schizophrenia, depression, and Alzheimer’s disease
• Challenges such as small study sizes, methodological weaknesses, and a shortage of music therapists hinder the widespread validation and implementation of music as an accepted adjunct therapeutic

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Music feels like an inseparable part of the festive season; store melodies, cheerful carols, and timeless classics evoke the spirit of celebration. Although music is important for festive cheer, its significance persists year-round. There are hundreds of millions of music interactions daily,¹ whether through passive listening or active playing.² Here, we explore the scientific research on music and mental health, shedding light on the ways music can potentially enhance our mental well-being during the holiday period and beyond.

When sound vibrations enter the auditory system, our brains undergo a remarkable processing journey, involving all four lobes of the cerebral hemispheres and the brainstem.³ Few daily activities engage more parts of the brain.³ Passive music engagement activates large-scale neural networks, including those involved in memory, emotion, attention, and movement.⁴ A study using functional magnetic resonance imaging revealed that familiarity with music matters; brain circuits in the broad emotion-related limbic and paralimbic regions and the reward circuitry were more active when listening to familiar versus unfamiliar music.⁵ Specifically, a metanalysis suggested that listening to familiar music involves a left cortical-subcortical co-activation pattern comprising significant clusters in the supplementary motor areas Brodmann area (BA 6), inferior frontal gyrus (IFG, BA 44), claustrum, and insula.⁴ Interestingly, one study found that listening to music elicits distinct patterns of brain activation depending on whether the particular piece of music is perceived as pleasant or unpleasant.⁶ Perceived pleasant music activates regions such as the inferior frontal gyrus, anterior superior insula, ventral striatum, Heschl’s gyrus, and Rolandic operculum.⁶ Conversely, perceived unpleasant music triggers activation in the amygdala, hippocampus, parahippocampal gyrus, and temporal poles, which are implicated in processing stimuli with negative emotional valence.⁶

Melodies and Mental Well-being: The Potential Therapeutic Power of Music

Music has potential profound impacts on mental well-being, particularly evident in clinical settings.⁷ Music used in therapeutic practices can be categorized as music therapy or music medicine.⁷ The American Music Therapy Association defines music therapy as the clinical, evidence-based use of music interventions to achieve individualized goals within a therapeutic relationship, conducted by a credentialed professional.^3,7 Music medicine involves passive listening to prerecorded music provided by medical personnel under the supervision of healthcare professionals other than music therapists.⁷

In hospitals, music has been used as a nonpharmacological intervention to improve patient outcomes, especially for patients in intensive care units.⁸ For example, a single-blind randomized controlled trial involving 36 patients receiving mechanical ventilation showed that listening to music reduced anxiety, pain, delirium, and the need for sedation compared with the groups exposed to noise reduction and silence.⁸ Similarly, a multicenter trial in the United States is investigating the efficacy of music versus silence in reducing delirium.^9,10

Music-based interventions have also shown promise in cancer treatment, particularly during chemotherapy infusions.¹¹ An open-label, multisite study of 750 patients scheduled to receive chemotherapy found that patients who listened to music experienced an increase in positive mood and a decrease in negative mood and distress compared with a control group with no music.¹¹ Another study in Italy involving 94 patients with breast cancer randomized to music therapy, virtual reality, or no music found that both virtual reality and music therapy may effectively alleviate anxiety and improve mood states, although virtual reality may be more effective in reducing anxiety, depression, and fatigue.¹²

Music therapy has been found to have potential benefits for patients with schizophrenia, depression, and, Alzheimer’s disease.^13-15 A study in China using functional magnetic resonance imaging in 56 participants with schizophrenia found that music engagement improved the functional circuitry of the right middle temporal gyrus, which is related to emotion and sensorimotor functions, compared with those who did not engage with music.¹³A meta-analysis of 421 participants examined the short-term effects of music therapy for depression, revealing that music therapy combined with treatment as usual, reduced anxiety and improved functioning more effectively than treatment as usual.¹⁴ For patients with Alzheimer’s disease, music therapy has shown promise.¹⁵ A study involving 298 participants found that music therapy enhanced memory and language abilities in patients with mild Alzheimer’s disease and reduced psychiatric symptoms in patients with moderate to severe Alzheimer’s disease.¹⁵

Sound Solutions: Challenges of Music and Mental Health

Despite the growing recognition of the potential benefits of music-based interventions for mental well-being, several challenges hinder its general widespread implementation and validation.^11,16 While preliminary studies suggest positive outcomes, existing studies have limitations, including small sample sizes and methodological weaknesses, such as vague descriptions of the music used.^{8,11,14,17,18} Additionally, these studies often overlook patients' musical backgrounds and preferences, which could be significant confounders.¹¹ Compounding these challenges is the shortage of qualified music therapists, with only a fraction of therapists available compared with the number of adults diagnosed with mental health conditions.¹ Despite these challenges, the American Psychological Association’s guidelines for schizophrenia acknowledges music therapy as a promising area for further investigation.¹⁹

Harmonious Therapy: Music as a Nonpharmacological Adjunct Therapeutic

As a nonpharmacological intervention, music-based interventions have shown promise in improving outcomes in intensive care, cancer treatment, and mental healthcare settings.^8,11,13-15 With further evidence and validation, music has the potential to be an effective adjunct treatment in support for patients with various psychiatric conditions.^14,16,20,21 So, feel free to embrace and recommend the potential of music, knowing that the benefits may reach far beyond what meets the ear.

Further reading

Cite this article as Harmonizing Minds–Exploring Music’s Impact on Brain Health. Connecting Psychiatry. Published June 2025. Accessed [month day, year]. [URL]

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January 2025