16. Exploration of the neuroregulatory mechanism of music rhythm therapy for depression under embodied cognition

Abstract Background Depression is not only characterized by persistent low mood, but also accompanied by comprehensive neurological and cognitive disorders such as dysfunction of the prefrontal and limbic systems, obstruction of emotional processing, and degeneration of physical perception. Traditional psychological intervention is effective in improving cognitive biases, but its repair at the physical experience level is limited. Embodied cognitive theory emphasizes the two-way interaction among emotions, body movements and cognitive processing, providing a new theoretical basis for music rhythm therapy. The rhythm structure can directly regulate attention, emotion initiation and cortical rhythm through the synchronous movement of beats, rhythms and the body. However, there is still a lack of systematic empirical research on its specific regulatory mechanism of the neural circuits of depression. Therefore, this study explores the neuroregulatory mechanism of music rhythm therapy on depression from the perspective of embodied cognition, aiming to reveal its improvement effects on emotional regulation, body synchronization processing, and neural activity patterns. Methods A total of 68 patients with depression were included in the study and randomly divided into the rhythm therapy group (n = 34) and the control group (n = 34). The rhythm therapy group received an 8-week embodied music rhythm intervention, including beat synchronization exercises, rhythm gait guidance, body rhythm response, and music-action-emotion matching tasks. The control group received conventional psychological education and relaxation training. Assess depression levels respectively before and after the intervention (Hamilton Depression Rating Scale, HAMD-17), emotion regulation ability (Difficulties in Emotion Regulation Scale, DERS), body awareness (Body Awareness Questionnaire, BAQ), which use the technology of electrical record prefrontal alpha inhibition index (Alpha Suppression Index, ASI), the Delta theta/power ratio (Delta/Theta Power Ratio, DTR) and rhythm (Rhythmic Entrainment Synchronization, RES) induced synchronization. In the subsequent analysis, all the above indicators will be directly abbreviated. Statistical tests were conducted using repeated measures analysis of variance. Results After 8 weeks, the HAMD-17 score of the rhythm therapy group decreased from 21.63 ± 4.12 to 12.74 ± 3.58, with an improvement of 41.1%, which was significantly better than 19.8% of the control group (p<.001). The DERS score decreased by 24.6% (p=.003), and the BAQ score increased by 18.3% (p<.01), indicating that emotional regulation and physical awareness improved simultaneously. The electroencephalogram (EEG) indicators showed that RES increased by 31.8%, ASI significantly enhanced (p=.009), and DTR decreased by 14.2% (p<.01), suggesting that rhythm training effectively promoted cortical excitability and the regulatory ability of the prefrontal - limbic circuit. Discussion The results show that music rhythm therapy within the embodied cognitive framework can effectively improve the emotional state, physical awareness, and neural rhythm synchronization level of patients with depression. Rhythm structure may enhance the activation level of the prefrontal cortex and improve the efficiency of emotional regulation by strengthening body-beat synchronization and promoting sensory-motor integration. The changes in electroencephalogram (EEG) indicators further support the important mechanism of rhythm-induced synchrony in the improvement of depression. The research provides preliminary evidence for the neuroscientific basis of rhythm therapy, but the sample size and intervention period remain limited. Future research can be combined with functional magnetic resonance to further verify the changes in neural circuits and explore the differences in therapeutic effects among different rhythm types, movement intensities, and embodied participation.