This review of research on the neuroscience of music-based interventions for pain highlights known research on the overlap of pain processing and reward networks, as well as the latest outcomes of investigations into the impact of sensorimotor synchronization with music on pain perception. The authors concisely summarize the foundational neurological mechanisms of music's effect on neurotransmitters, which form the basis of their own studies on the effects of active engagement in music listening and in music therapy on pain. Though the authors note that there are several mechanisms at work that can be challenging to isolate, the review leads to a summary of research on the effects of musical movement synchronization on pain. This summary then hypothesizes how moving in time to music likely increases activity in the extrinsic mode network and decreases activity in the default mode network (DMN); such a shift of cognitive resources has implications for mental health conditions exacerbated by mental activity implicated in the DMN such as mental rumination, auditory hallucinations, PTSD flashbacks, and so on. This hypothesis seems to be corroborated by one authors' recent research highlighted here showing that persistent negative thoughts can also manifest in physical pain. The authors conclude with recommendations for patients to actively engage in music, particularly sensorimotor movement to music, so that they may not only experience pain relief but also improve their mental states.
The review is well-written for an academic audience. The authors only give very general recommendations on the implications of this body of work on practice, and do not discuss implications for research despite what else there is to be learned from such work. To be sure, this is not a comprehensive review of the literature on this topic, and many other reviews on this topic exist. The importance of this review, however, is in the synthesis of literature on sensorimotor synchronization to music and how these studies can inform not only music-based interventions for pain but have the potential to affect many other challenging mental health conditions. Thus it is interesting that the authors did not recommend further research into these mechanisms for these conditions, rather they simply recommended sensorimotor movement to music for negative thoughts and moods. Furthermore, the tone of these recommendations is quite positive (lines 29-30: “… has the potential to provide immediate and effective relief”) without addressing the duration or durability of relief, or the long-term utility of such an intervention, including the long-term neuroplastic effects of using music in this way.
The figures and their captions are clear and support the first part of the review well.
I have very little to critique other than perhaps clarification on the lack of discussion on what the authors believe should be studied next, and more practical recommendations for providers and patients beyond “integrating music medicine and music therapy into clinical practice” (line 54). It may be necessary to provide more specific and concrete recommendations for readers—whether that is a referral to a music therapist, singing with a community choir, and so on.

Thank you for the opportunity to review this article.