Getting to the Heart: Autonomic Nervous System Function in the Context of Evidence-Based Music Therapy

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As evidence-based music therapy turns its attention to physiological responses, it will need outcome measures that are grounded in an understanding of mechanisms which drive physiological activity. Despite strong indications for the involvement of the autonomic nervous system (ANS) in health and disease and its response to music, few studies have systematically explored the therapeutic or interventional effects of music on ANS dysfunction. After reviewing the experimental and interventional lit- eratures on music and ANS response, a ‘‘neurovisceral integration’’ perspective on the interplay between the central nervous system and ANS is introduced, and the associated implications for physiological, emotional, and cognitive health are explored. The construct of heart rate variability is discussed both as an example of this complex interplay and as a useful metric for exploring the sometimes subtle effect of music on autonomic response. Suggestions for future investigations using musical interventions are offered based on this integrative account.