1643 - The Use of Music Therapy for Behavioral Outcomes in Patients with Disorders of Consciousness

Objectives: Music therapy (MT) offers a non-invasive auditory modality to target behavioral responsiveness in patients with acquired brain injury. While a variety of outcomes have been used to assess response to MT in patients with disorders of consciousness (DoC), including EKG, fMRI, and EEG, behavioral outcomes offer promise for understanding the clinical impact of MT. In this review, we summarize the use of music therapy for behavioral-based outcomes in patients with DoC.

Design: We conducted a literature search using the keywords “music therapy”, and “disorders of consciousness”, and related terms published from 2010 - 2024 on PubMed. Inclusion criteria consisted of articles written in English, participants aged 16 and older, fit the criteria of music therapy, and the presence of one or more behavioral assessments to assess the effect of music therapy. Research articles and letters were included.

Results: Of the 15 studies screened and identified, 8 articles were included based on inclusion and exclusion criteria, with sample sizes ranging from n=7 to n=90. Of the 8 studies, 3 used the Glasgow Coma Scale (GCS), 3 studies used the Coma Recovery Scale-Revised (CRS-R), and 1 study each used the Sensory Modality Assessment and Rehabilitation Technique (SMART), Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC) and an observational approach. Of the 8 studies, 50% found statistically significant differences in responsiveness in the experimental group status post-music therapy, while 2 studies found positive but nonsignificant trends, and 2 studies found no significant difference in behavioral assessment measures after music therapy.

Conclusions: Music-based interventions demonstrate promising changes in responsiveness in patients with DoC and more research is warranted to evaluate the use of MT in patients with DoC. While early literature has demonstrated physiological response to music, further research into behavioral assessments is necessary to evaluate the clinical impact of MT.