Role of Music Therapy in Neurocritical Care for Patients with Acute Brain Injury with Disorders of Consciousness: A Narrative Review and Proposed Framework for Practice.

Abstract

Music therapy (MT) holds promise as a treatment for patients with severe acute brain injury (SABI) with disorders of consciousness (DoC) admitted to critical care units. MT leverages the intrinsic properties of music to engage patients and their families, promoting recovery through neurological, psychological, and physiological mechanisms. Although MT is routinely practiced in intensive care and rehabilitation settings, its applications in a neurocritical care context during acute DoC treatment and recovery are underexplored. Further, the subjective nature of music, music preferences, and the variability in patient responses to music-particularly in patients with SABI and DoC-pose unique challenges for implementing a one-size-fits-all approach. Through our institution's experience with MT and a review of previously published evidence, this article illustrates the application of our MT approach as a noninvasive, holistic, and individualized intervention. A case vignette explores MT in the clinical care of a patient with SABI admitted to the neurocritical care unit across a 9-week period, demonstrating the potential of MT to enhance quality of care and recovery outcomes over time. A family impact statement and emerging practice framework are also included to further elucidate the ways in which MT may enhance quality of care and patient recovery in neurocritical care settings.