Effects of music interventions on disorders of consciousness: a systematic review and meta-analysis

Aoyi Li, Huimin He, Yingcong Liu, Qiyu Jiang, Yupeng He

Objective The study aimed to systematically evaluate the effects of music intervention on outcomes related to the recovery of consciousness in patients with disorders of consciousness (DOC). Methods Databases including PubMed, Web of Science, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and ProQuest were systematically searched from January 1970 to December 2025 to identify relevant randomized controlled trials (RCTs). The literature was screened based on pre-established inclusion and exclusion criteria, and the review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool (RoB 1). Results A total of 12 randomized controlled trials (RCTs) involving 926 patients with disorders of consciousness (DOC) were included. As the types of outcome indicators reported in the included studies varied, the number of studies included for each outcome also differed. Specifically, five studies were included in the analyses of Glasgow Coma Scale (GCS) scores and the GCS-based awakening rate, whereas two studies were included in the analyses of GCS scores of > 8, the Coma Recovery Scale-Revised (CRS-R), and the National Institutes of Health Stroke Scale (NIHSS). A meta-analysis showed that GCS scores were significantly higher in the music intervention group than in the control group (mean difference (MD) = 2.32). The analyses of GCS scores of > 8 showed that a higher proportion of patients in the music intervention group achieved a GCS score of > 8 (odds ratio (OR) = 5.98). The awakening rate also indicated that the music intervention group was significantly superior to the control group (OR = 3.76). For secondary outcomes, the music intervention group showed higher CRS-R scores (MD = 2.86) and lower NIHSS scores (MD = −1.24). Conclusion Music intervention may help improve consciousness levels and awakening-related outcomes in patients with disorders of consciousness and may serve as a safe and non-invasive adjunctive measure in rehabilitation nursing care. However, more high-quality randomized controlled trials are needed to further verify its effects and mechanisms. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261354569 , Identifier: CRD420261354569.