Role of Electroencephalography in the Assessment of Cortical Responses Elicited by Music Therapy in Burn Patients Undergoing Intensive Care

Music therapy (MT) is increasingly being integrated into intensive care unit (ICU) settings to modulate pain, stress, and emotional dysregulation. Although clinically promising, objective biomarkers for quantifying its neurophysiological effects are still missing. In this context, the electroencephalogram (EEG) represents a valid tool to assess cortical dynamics associated with cognitive-affective engagement elicited by MT. Our study aims to evaluate the role of electroencephalography as an objective tool for monitoring cortical responses to MT in the ICU. EEGs acquired from nine burn patients undergoing MT in the ICU were considered. Signals were preprocessed to improve the signal-to-noise ratio. Then, six frequency bands (delta, theta, alpha, beta, gamma, and sensorimotor rhythm) were extracted to compute band powers and derive 37 involvement indexes, which were statistically compared across three experimental phases: before, during, and after MT. Results demonstrate that involvement indexes effectively capture neurophysiological shifts induced by MT. Significant differences were observed in 22 indexes when comparing During-MT and Post-MT phases, with 2 indexes being statistically different also when comparing During-MT and Pre-MT phases; 5 indexes differed statistically when comparing Pre-MT and Post-MT phases. These results suggest a transient cortical engagement elicited during MT in ICU settings. Our findings align with previous research reporting EEG (and certain EEG-derived involvement indexes) sensitivity to capture music-induced cognitive and emotional modulation. This confirms electroencephalography potential to objectively reflect MT effects and support its integration in multidisciplinary burn care; however, analysis on larger cohorts is necessary to validate EEG as a clinical tool in MT.