Potential Effects of Music on Non-Motor Symptoms in Parkinson's Disease: Translating Mechanisms to Therapy

Non-motor symptoms (NMSs) are highly prevalent in Parkinson's Disease (PD) and contribute significantly to disease severity, progression, and diminished quality of life. NMSs are rooted in both physiological and psychological domains and include emotional dysfunction, autonomic dysregulation, cognitive impairment, pain exacerbation, and neural deficits. While pharmacological approaches are often employed for the alleviation of non-motor symptomology, modest efficacy and adverse side effects may limit their practical utility for individuals with PD, leaving the need for the identification of complementary approaches. Music interventions have emerged as potential adjunctive therapeutic approaches that may positively modulate NMSs in both physiological and psychological domains. Physiologically, music interventions have been shown to alter autonomic activity and pain/sensory perceptions and mediate neurotransmitter release related to arousal, physical effort, and stress. Psychologically, music interventions, both passive and active, have been shown to modulate emotional regulation, motivation, attention, and cognitive performance. Emerging evidence utilizing neuroimaging and behavioral techniques further supports this and suggests music-induced benefits even in the presence of advancing neurodegeneration. Overall, findings from this narrative review suggest music may serve as a potential non-invasive adjunctive therapeutic tool to counteract PD-induced NMSs by adaptively modulating physiological and psychological processes. This narrative review aims to gather current evidence on the physiological and psychological mechanisms underlying the benefits of music and proposes potential therapeutic translation for NMSs in PD. Furthermore, current difficulties, gaps in knowledge, and needs for future research are discussed with the goal of informing directions for clinical translation.