MUSICAL NEUROMODULATION IN ALZHEIMER'S DISEASE: A SYSTEMATIC REVIEW OF RESPONSE BIOMARKERS AND PREDICTORS OF CLINICAL EFFICACY

Abstract

This article sought to identify factors that influence the response of people with Alzheimer's disease to musical interventions. We conducted a systematic review, searching the PubMed and BVS databases, with 1,546 and 190 records respectively. We applied rigorous inclusion criteria: the last 5 years, clinical trials, randomized clinical trials, clinical studies, and controlled clinical trials, in addition to the requirement for free full text. Subsequently, 43 articles remained from PubMed and 23 from BVS. After reading the titles, we arrived at 22 studies directly related to the topic. The findings indicate that music is capable of modifying the connectivity of important brain networks — such as the frontoparietal, salience, and default mode networks — as demonstrated by studies using functional magnetic resonance imaging. Physiological markers such as cortisol and alpha-amylase are also promising for assessing treatment response, although they show great variability among individuals. Among the factors that help predict better outcomes, the following consistently stood out: moderate to severe stage of dementia, the presence of psychomotor agitation, the home context with caregiver involvement, the active format of the sessions, and, above all, the degree of personalization of the intervention. We conclude that progress toward precision music therapy in Alzheimer's disease depends on carefully identifying these factors, allowing for more targeted interventions.