Systematic review and meta-analysis reveal positive therapeutic effects of music in brain damage rehabilitation

Antonio Salas^1*Laura Navarro²Nour El Zahraa Mallah¹Jacobo Pardo-Seco²Alberto Gómez-Carballa²Sara Pischedda²Wiktor Nowak²Emma Segura³Antoni Rodriguez-Fonells³Federico Martinón-Torres¹

• ¹University of Santiago de Compostela, Santiago de Compostela, Spain
• ²Instituto de Investigacion Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
• ³Institut d'Investigacio Biomedica de Bellvitge, Barcelona, Spain

Brain damage (BD) caused by stroke, traumatic brain injury (TBI), or neurodegenerative conditions often results in persistent cognitive, motor, and emotional impairments. Music-based interventions (MI), including active (singing, instrument playing) and receptive (music listening, music therapy) approaches, have been explored as adjunctive rehabilitation strategies; however, the, but evidence remains fragmented. This systematic review and meta-analysis synthesize available research on the effects of MI on functional recovery following BD, due to, including both acquired and traumatic brain injury (ABI), including both traumatic and non-traumatic brain injuries (TBI and non-TBI). From a total of 558 868 publications screened in PubMed, Embase, Scopus, Cochrane Library, Web of Science, and ClinicalTrials.gov, 70 90 were included, of which 31 41 met the criteria for quantitative evaluation and meta-analysis, to assess the state-of-the-art of research on music and BD in the fields of neuropsychology and cognitive sciences. The reviewed studies span a range of methodologies, including randomized controlled trials and qualitative research, and incorporate diverse MI strategies, such as active music-making, structured listening, and improvisational techniques. The findings indicate that music supports recovery across motor, cognitive, and, albeit to a lesser extent, communicative and psychosocial domains. The findings suggest beneficial effects of MI, particularly in gait function (z=3.1646, P-value<0.01), upper extremity function (z=5.186.11, P-value<0.01; UEF), communication (z=2.753.21, P-value<0.01), cognitive rehabilitation (z=4.52, P-value<0.01), and emotional, behavioral, and social outcomes (z=2.4635, P-value=0.0102); notably, these effects were often supported by consistent statistical significance across multiple subgroup analyses (e.g. gait, UEF). This study highlights the therapeutic potential of music in neurorehabilitation and supports its integration into multidisciplinary treatment programs. Despite these promising findings, methodological heterogeneity, small sample sizes, and short intervention durations limit the generalizability of results. While BD can impair specific aspects of musical processing, such as in cases of amusia, capacities like musical memory and emotional responsiveness to music often remain preserved. Notably, prior musical training may confer resilience, indicating a potential protective role of long-term musical engagement. Overall, tThe evidence suggests that music may modulate key neurobiological pathways in BD, supporting its integration into evidence-based neurorehabilitation programs.