The Impact of Music Therapy and Music-Based Interventions on the Psychiatric and Psychological Outcomes of Traumatic Brain Injury: A Systematic Review

Traumatic brain injury (TBI) is caused by an external force to the head, which disrupts brain functioning and is associated with psychiatric and neurobehavioral issues, engendering a need for rehabilitative care. Recent literature has discussed the effectiveness of applying music therapy (MT) and music-based interventions (MBIs) for a range of psychopathologies, noting the capacity for music to induce feelings of pleasure and its relationship to brain reward circuitry. However, whether music can be used to effectively mitigate the social, emotional, and behavioral difficulties of TBI is currently unclear. This systematic review investigates the impact of MBIs (including MT) on psychiatric and psychological outcomes of TBI. We conducted a search for studies examining the effect of MBIs on psychological symptoms, mental health disorders, and behavior in individuals with a TBI history. Eight studies were included. Outcomes consisted of stress, mood, anxiety, depression, social interaction, agitation, inertia, and sleep quality. Included articles were evaluated using Cochrane Risk of Bias tools. The studies included in this review have implications that MBIs may improve agitation, stress, and depression in adult TBI patients. MT studies reported improvements in mood and inertia, and more often used active music engagement. Music-based intervention studies reported increased social interaction and sleep quality. Our risk of bias assessment suggests that design limitations limit strong conclusions about MBI efficacy in TBI. Increasing the methodological rigor in future studies is necessary to reduce the risk of bias and support evidence-based MBI approaches for TBI rehabilitation.