Search Results (371)

Background: Alzheimer’s Disease (AD) is the most common form of dementia and is characterized by progressive cognitive decline and neurodegeneration. In Italy, AD represents a major public health and socio-economic challenge. This review aims to summarize current Italian research on pharmacological and non-pharmacological interventions, including preclinical studies, clinical trials, rehabilitative approaches, and emerging neuromodulation techniques, highlighting contributions and future directions. Methods: A narrative review of the literature was conducted, focusing on Italian preclinical and clinical studies, observational and real-world evidence, cognitive and physical interventions, music therapy, non-invasive brain stimulation (rTMS, tDCS, tACS), and digital or home-based rehabilitation programs. Results: Italian research has explored different pharmacological strategies, including multitarget compounds, eptastigmine, rotigotine, and combinatorial therapies (donepezil-memantine, citicoline addition). Non-pharmacological interventions, such as cognitive stimulation, motor rehabilitation, music therapy, and multidimensional programs, demonstrated benefits on cognition, behavior, daily functioning, and caregiver well-being. Non-invasive neuromodulation techniques, targeting the dorsolateral prefrontal cortex and precuneus, showed promising effects on memory, attention, and executive functions, especially when combined with cognitive training. Digital health technologies, including telerehabilitation and home-based brain stimulation programs, further enhanced accessibility and adherence. Challenges remain due to fragmented research, small sample sizes, and limited standardization. Conclusions: Italian research on AD reflects a growing emphasis on integrated, multidimensional, and technologically advanced approaches. Strengthening preclinical studies, promoting multicenter collaborations, and combining pharmacological, cognitive, and neuromodulatory strategies may enhance therapeutic efficacy and patient quality of life. Continued investment in innovation and multidisciplinary research positions Italy to contribute meaningfully to global AD management and prevention. Full article

Objectives: This systematic review seeks to provide an in-depth overview of current research on tele-music interventions in supportive cancer care and identifies key areas where further research is warranted. Methods: A comprehensive search was conducted across four electronic databases (Scopus, Embase, Web of Science, and PubMed) without any data restrictions and according to the PRISMA guidelines. The primary outcome measure was the effect of tele-music interventions on psychosocial functioning. Results: Of the 2.043 articles initially identified, nine studies met the inclusion criteria and were selected for qualitative analysis. Among the music interventions, considerable variation was observed regarding delivery format and techniques employed. Most interventions were delivered remotely through Zoom, and in all but one study, a music therapist was involved. Outcome measures addressed various psychosocial and physical symptoms, most frequently anxiety, for which findings were mixed: three studies reported significant reductions, whereas two others observed no or only limited improvement. Conclusions: The results suggest that tele-music interventions are effective in reducing a range of cancer-related symptoms, including stress, anxiety, depression, and pain. However, the heterogeneity in study designs and methodological limitations hampered direct comparison and overall effectiveness assessment. Additionally, digital technologies hold considerable potential for the accessible and cost-effective delivery of music interventions. Full article

Global population aging has created an urgent need for effective interventions to mitigate cognitive–emotional decline in older adults. Given the limitations of pharmacological treatments and cognitive–behavioral therapy in terms of adherence and side effects, this study explores the potential of non-pharmacological approaches through a randomized controlled trial. Seventy-eight older adults (60–75 years) were assigned to one of three groups: groove music + sports dance (GODA), conventional music + sports dance (CODA), or a control group (CON). Over 12 weeks, participants engaged in three 60-min sessions weekly, each featuring a 45-min core training block. All interventions were delivered at a target low-intensity level (RPE 11–13, ‘somewhat hard’), with real-time RPE spot-checks confirming that between-group differences never exceeded 1 unit, thereby ensuring consistent exertion levels. Pre- and post-intervention assessments measured emotional regulation, executive function, neuromuscular coherence (β/γ-band sEMG), and prefrontal connectivity (fNIRS). Under low-intensity conditions, GODA significantly improved emotional regulation and executive functions—including working memory and planning—compared to CODA and CON. Furthermore, GODA participants exhibited increased neuromuscular coherence in β/γ-bands and enhanced mPFC-lPFC connectivity, which correlated with improved sensorimotor integration. In contrast, high-intensity interventions showed no group differences. These findings indicate that groove music combined with sports dance improves cognitive–emotional function and neuromuscular coordination in older adults, particularly during complex movements. The rhythm-driven benefits of GODA support its clinical utility as a feasible non-pharmacologic intervention to mitigate age-related cognitive–emotional impairments. Full article

The Unbroken Rehabilitation Center in Lviv illustrates how architectural design can support recovery in post-conflict conditions. Drawing on concepts of healing environments, evidence-based design, and trauma-informed architecture, this study aimed to identify architectural strategies that enhance physical and psychological rehabilitation in war-affected populations. A mixed-method approach was applied, combining field observations, architectural analysis, and user surveys triangulated with interviews and documentation review. Results show that decentralised layouts, daylight access, barrier-free circulation, and cross-laminated timber (CLT)-based vertical expansion contribute to therapeutic effectiveness. Survey data from 45 respondents confirmed very high ratings for accessibility (9–10/10) and strong appreciation of group therapy rooms (9.0), art therapy (8.8), and music therapy (8.7). These findings highlight the value of sensory and symbolic elements, including natural materials and culturally embedded art. While the exploratory character and uneven respondent distribution limit generalisability, the triangulated methodology enhanced reliability and revealed clear user trends. The study demonstrates that architectural design can actively support resilience and rehabilitation in war-affected contexts, offering transferable insights for future post-conflict reconstruction. Full article

Music is a near-universal anthropological and sensory phenomenon that engages distributed brain networks and peripheral physiological systems to shape emotion, cognition, sociality, and bodily regulation. Evidence from electrophysiology, neuroimaging, endocrinology, randomized controlled trials, and longitudinal training studies indicates that both receptive and active musical experiences produce experience-dependent neural and systemic adaptations. These include entrainment of neural oscillations, modulation of predictive and reward signaling, autonomic and neuroendocrine changes, and long-term structural connectivity alterations that support affect regulation, cognition, social functioning, motor control, sleep, and resilience to neuropsychiatric illness. This narrative review integrates mechanistic domains with clinical outcomes across major conditions, such as depression, anxiety, schizophrenia, dementia, and selected neurodevelopmental disorders, by mapping acoustic and procedural parameters onto plausible biological pathways. We summarize how tempo, beat regularity, timbre and spectral content, predictability, active versus passive engagement, social context, dose, and timing influence neural entrainment, synaptic and network plasticity, reward and prediction-error dynamics, autonomic balance, and immune/endocrine mediators. For each condition, we synthesize randomized and observational findings and explicitly link observed improvements to mechanistic pathways. We identify methodological limitations, including heterogeneous interventions, small and biased samples, sparse longitudinal imaging and standardized physiological endpoints, and inconsistent acoustic reporting, and translate these into recommendations for translational trials: harmonized acoustic reporting, pre-specified mechanistic endpoints (neuroimaging, autonomic, neuroendocrine, immune markers), adequately powered randomized designs with active controls, and long-term follow-up. Contextual moderators including music education, socioeconomic and cultural factors, sport, sleep, and ritual practices are emphasized as critical determinants of implementation and effectiveness. Full article

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects social interaction, communication, and behavior. Traditional interventions such as Applied Behavior Analysis and sensory integration therapy often lack a person-centered approach. Art therapy offers a creative and holistic alternative for supporting children and adolescents with ASD. Objectives: This study systematically reviewed and evaluated the effectiveness, modalities, formats, and methodological quality of randomized controlled trials (RCTs) involving art therapy interventions for children and adolescents with ASD. Methods: A systematic search of eight databases identified 12 RCTs involving art therapy for children and adolescents with ASD. Intervention outcomes, formats, and methodological rigor were assessed through this systematic review. Methodological rigor was assessed using the Cochrane ROB 2.0 tool, and the Delphi list with four additional items. Results: Art therapy showed promise in reducing ASD symptoms and stress-related symptoms, and in improving social communication, motor skills, language, and neurodevelopment. Most studies had limitations, including small sample sizes, short durations, a high risk of bias, and low methodological quality. Conclusions: Although existing studies suggest that art therapy may benefit children and adolescents with ASD, further rigorously designed studies are required to establish its efficacy and inform evidence-based practice. Full article

Background: Dental anxiety is a common challenge in paediatric dentistry, often leading to avoidance of treatment and compromised oral health. Non-pharmacological interventions such as music therapy have gained increasing attention as safe and cost-effective alternatives to pharmacological approaches. Although several clinical studies have examined the impact of music on children’s dental anxiety, the evidence has not yet been systematically summarised with quantitative synthesis. Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of music therapy in reducing dental anxiety and fear among paediatric patients. Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library from inception to August 2025. Randomised controlled trials (RCTs) evaluating music therapy for dental anxiety in children were included. Primary outcomes were self-reported dental anxiety/fear scales and physiological measures (heart rate, blood pressure, oxygen saturation). Risk of bias was assessed using the revised Cochrane risk of bias tool (RoB 2, version 2019; Cochrane Collaboration, London, UK) Meta-analyses were performed using a random-effects model with Review Manager (RevMan, version 5.4; Cochrane Collaboration, London, UK). Results: Seven randomized controlled trials (RCTs) involving 476 children aged 4–14 years were included. Music therapy significantly reduced self-re-ported dental anxiety compared with control groups (SMD = −0.48, 95% CI: −0.72 to −0.25, p < 0.001). Heart rate was also significantly reduced (SMD = −0.42, 95% CI: −0.68 to −0.16, p = 0.002), whereas changes in blood pressure and oxygen saturation were not statistically significant. The overall risk of bias was moderate, with most concerns related to blinding. Conclusions: Music therapy is an effective non-pharmacological intervention to reduce dental anxiety in children, particularly improving subjective anxiety and physiological arousal as measured by heart rate. Its integration into paediatric dental practice may enhance cooperation and treatment outcomes, offering a safe, inexpensive, and child-friendly approach. Full article

Background: Speech loss is recognised as one of the most devastating outcomes for individuals with ALS, yet active speech intervention is rarely targeted in this population. Clinicians face significant challenges in managing dysarthria associated with ALS due to the rapidly progressive nature of the disease, historical concerns around intensive exercise accelerating decline, and an absence of direction on restorative and compensatory intervention strategies in current clinical care guidelines. This review evaluates the scope and quality of evidence for speech treatments in ALS to identify knowledge gaps and establish research priorities to guide clinical care. Methods: Studies were retrieved from six electronic databases (PubMed, CINAHL, Embase, Cochrane library, Web of Science, and PsycINFO). Results: Four studies met inclusion criteria. Treatment approaches included: music-based speech therapy; multisubsystem speech rehabilitation program, tongue strengthening and articulation training; and Lee Silverman Voice Treatment-LOUD^® combined with additional voice and articulation therapy. Sample sizes were small, with all studies demonstrating notable methodological weaknesses. The limited evidence base, marked by conflicting results and methodological flaws, prevents any reliable conclusions about treatment effectiveness. Conclusions: Despite the prevalence and impact of dysarthria in this population, evidence for speech treatment remains sparse, of generally low quality, and provides limited guidance for clinical practice. The changing perspective on exercise in ALS warrants rigorous investigation of tailored dysarthria interventions for this population that are minimally fatiguing and enhance speech by making use of residual physiologic support. Full article

This study investigates how preferences for sad or happy music influence the network structures linking depressive symptoms and meaning in life. Analyzing data from 1681 college students, results indicate that individuals who listen to sad music display a denser network structure with stronger connections between depressive symptoms and meaning in life, while those favoring happy music exhibit a more dispersed network with weaker connections. The Sad Music Group showed higher global strength, suggesting a tightly knit network, whereas the Happy Music Group had lower global strength, implying greater flexibility among nodes. These findings highlight distinct network configurations between the two groups, offering insights into the interplay between music engagement and psychological well-being. By identifying key nodes and connectivity, we can develop more targeted therapy interventions. However, it is crucial to consider individual differences and contextual factors that influence how music affects psychological well-being. Full article

Individuals with severe intellectual disabilities and challenging behaviour often face limited access to effective therapeutic interventions, as conventional approaches like cognitive behavioural therapy may not be suitable. Creative arts therapies (CATs), psychomotor therapy, and play therapy have emerged as promising non-verbal alternatives, yet their use in this population remains underexplored. This scoping review aimed to map and synthesize the existing evidence on the application and outcomes of these interventions for individuals with severe intellectual disabilities and challenging behaviour. A comprehensive search was conducted across eight databases in May 2023 (with an update of the search in June 2025). Thirteen studies met the inclusion criteria, namely eight quantitative and five qualitative designs. Interventions included music therapy (n = 7), art therapy (n = 4), a combination of both (n = 1), and play therapy (n = 1); no studies on psychomotor therapy were identified. Reported outcomes were grouped into five domains: cognitive, psychological and emotional, social and interactional, communicative, and creative domain. Improvements were observed in areas such as attention, emotional regulation, social responsiveness, and communicative expression, particularly in structured and attuned therapeutic environments. However, most studies had methodological limitations, including small sample sizes and limited standardisation. These findings suggest potential benefits of CATs and play therapy, while highlighting the need for further research into underrepresented modalities and the use of rigorous single-case experimental designs. Full article

Background: Supported infant-directed singing (IDS) for parents and their preterm infants has proven beneficial for parents and preterm infants’ health and relationship building. Studying parent–infant contingent interactions through behavioral observations is an established method for assessing the quality of interactions. Very few studies have measured contingency between parent and preterm infants in the neonatal period during supported IDS. Methods: We conducted a feasibility study to assess the possibility of analyzing parent–very preterm infant dyads’ contingency during supported IDS in the NICU. We recruited four mother–infant dyads and video-recorded a single music therapy (MT) session before their discharge from the hospital. Two independent researchers coded three selected segments (beginning, middle, and end) from each video, according to adapted behavioral scales with inter-rater agreement analysis. Contingency between infant and maternal behaviors was analyzed. Results: Twelve video segments were coded. High inter-rater agreements (Cohen’s kappa) were found for infant eye-opening (0.93), hand positions (0.79), and head orientation (0.94), as well as maternal head orientation (0.95) and vocalizations (0.95). During supported IDS, increased infant head orientation toward the mother, eyes closed, as well as maternal head orientation toward the infant (all p < 0.001), were recorded compared to no IDS. Direction of the maternal head toward her infant was contingent on the infant’s closed eyes, extended hands, and head not toward mother. Conclusions: This feasibility study demonstrates contingency between mothers and their preterm infants’ specific behaviors during IDS. These interactions can be analyzed through video segments with high inter-rater agreement. The method described might help in evaluating other modalities that might be related to contingency. Recent advances in AI can make this tool easier to accomplish, with further studies to evaluate the importance of contingency for child development. The findings suggest that supported IDS influences infant attention and regulation. Full article

Background and Objectives: Music therapy has a long tradition in palliative care, and recent studies have investigated its Neuro-Psycho-Endocrine-Immunological (NPEI) effects in terminally ill patients. Despite numerous published articles, there is a lack of a compendium connecting the physiological basis of music therapy with the specific musical elements most effective in end-of-life settings. This narrative review aims to synthesize current evidence on the physiological mechanisms underlying responses to music, with a focus on terminal patients and implications for nursing practice. Materials and Methods: For quality and possible reproducibility, a narrative review was conducted in accordance with Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. The review targeted articles from the past five years indexed in PubMed, CINAHL, Cochrane Library, Embase, Scopus, Web of Science, and PsycInfo, supplemented by additional relevant references identified through manual searching. The PICOS framework was performed to structure the search strategy and study selection, focusing on studies relevant to the biological effects of music therapy in end-of-life care and their practical implications for nursing care. Results: The neurophysiology of music perception in terminal patients is complex, involving a wide array of clinical and cultural factors. Key musical elements—such as rhythm, melody, harmony, tempo, and mode—can influence physiological and psycho-emotional responses. Music therapy interventions, when tailored to the individual’s preferences and cultural background, may modulate parameters like heart rate, blood pressure, stress hormone levels, and pain perception. Evidence supports the need for individualized approaches and highlights the NPEI rationale for integrating music therapy into end-of-life care. Conclusions: A deeper understanding of the scientific mechanisms discussed in this narrative review can enhance the effectiveness of music therapy interventions in end-of-life settings. Nursing practice can benefit by integrating evidence-based selection of musical pieces and personalizing interventions to the clinical and cultural profile of each patient. Further interdisciplinary research is needed to establish standardized criteria for music therapy in palliative care and to optimize outcomes for terminally ill patients. Full article

Background and Objectives: Music therapy has been used as a non-pharmacological treatment for neurological conditions, supporting cognitive, psychosocial, behavioural and motor functions. Although it is evidence-based, safe, and cost-effective, music therapy remains uncommon in neurorehabilitation services, largely due to a lack of quality research. This review aims to understand the effect of music therapy on psychological outcomes for neurological conditions using randomised clinical trials (RCTs). Materials and Methods: A systematic review of literature published in four databases (PsycINFO, CINAHL, PubMed, and Scopus which is inclusive of Medline and EMBASE) from 1 January 2015 to 31 January 2025 was performed. Results: Ten RCT’s comprising 469 participants were included in this review, with seven studies synthesised using a systematic review without meta-analysis approach. MT was found to improve cognitive function in individuals with Parkinson’s disease (PD) and Traumatic Brain Injury (TBI), but not in those with stroke or Huntington’s disease (HD). In HD, improvements in cognitive function were noted in the comparator group. MT led to significant improvements in emotional well-being in stroke survivors, though not in mood. Behavioural outcomes did not significantly improve in HD, while quality of life improved following MT for individuals with multiple sclerosis (MS) and stroke. Conclusions: Overall, MT was perceived as a positive intervention with potential psychological benefits. However, findings were mixed, and the heterogeneity of population, intervention, comparator, outcomes, and study design limited the ability to detect group differences and reduced confidence in the findings. Future research should focus on larger-scale RCTs that reduce bias, accommodate population diversity, and clearly define and distinguish MT from treatment-as-usual. Better standardisation of outcomes and improved reporting will be essential to evaluate the efficacy of music therapy in neurological conditions and strengthen the evidence base for its use in clinical practice. Full article

Background: The increasing demand for care in hospital settings, often at a high intensity, requires organizing work according to 24 h shifts. Nevertheless, shift work (SW), especially at night, alters the circadian rhythm, negatively affecting the psychophysical health of nurses, compromising their quality of life, and jeopardizing patient safety. Shift-work-related diseases (SWDs) can arise from these disruptions. Methods: This systematic review aims to evaluate the effects of several types of medical, psychotherapeutic, and educational interventions and strategies on shift-work-related diseases (SWDs). The databases PubMed, Embase, Web of Science, and Cochrane were searched using the MESH terms “shift work” and “nurses” from January 2015 to March 2025. A total of 43 articles were included in the final analysis. Results: Quantitative findings from the studies showed, for example, improvements in sleep quality scores ranging from 15% to 40% with optimized shift planning, reductions in fatigue scores by 20–35% through strategic napping, and moderate effect sizes for light therapy interventions. Physical activity and relaxation techniques were associated with a 10–25% improvement in subjective well-being indices, while meal timing interventions led to reductions in gastrointestinal symptom prevalence by up to 18%. The selected articles were discussed by dividing them according to the type of intervention applied to shift nurses, namely improvement of shift planning, light and temperature modulation, introduction of napping, supplementation, meal management, psychotherapy, sleep education, physical activity, relaxation techniques and yoga, music therapy, and aromatherapy. This categorization was performed to highlight the range of strategies tested and their relative quantitative impact. Conclusions: There is evidence that SWDs can be mitigated through targeted interventions and strategies. The limitations of the studies examined include small sample sizes, extreme heterogeneity of follow-up, the few numbers of randomized controlled trials, and the prevalence of female or Intensive Care Unit nurses in study samples. Further research should focus on large-scale randomized controlled trials, multicenter longitudinal studies, and the evaluation of the most promising interventions—particularly light therapy, optimized shift scheduling, and structured napping protocols—to assess their long-term efficacy and generalizability. Full article

Background. Parkinson’s Disease (PD) is a neurological condition that can severely impair gait, often through changes to gait parameters including stride length, velocity, and variability. Therapeutic interventions such as Rhythmic Auditory Stimulation (RAS^®) target gait dysfunction in PD by using the regular beat of music or metronome clips to cue normalized walking patterns. Previous research has suggested that auditory cue properties (e.g., familiarity and groove) and individual factors (e.g., beat perception ability and susceptibility to dual-task interference) influence auditory cueing treatment efficacy in healthy young and older adults; however, optimization of rhythmic cueing across individuals with PD remains understudied. Methods. To address this, we explored the effects of familiarity, groove, beat perception ability, and synchronization instructions on gait in patients with PD during accelerated auditory cues. Individuals with idiopathic PD were randomized to walk freely or synchronized to music and metronome cues played 10% faster than their baseline walking cadence. Musical stimuli varied in self-reported familiarity and perceived groove and beat perception ability was assessed to classify participants as good or poor beat perceivers. Results. Overall, high-groove music and synchronized walking elicited faster gait patterns compared to low-groove music and free walking, respectively, as demonstrated by increased gait velocity and cadence. Familiarity and beat perception ability did not significantly affect gait in individuals with PD. Discussion. Altogether, our results indicate that high-groove music and synchronized walking lead to the greatest gait improvements during cueing, regardless of beat perception ability. Conclusion. Future studies and clinical interventions should consider stimulus type and synchronization instructions when implementing cueing therapies for gait dysfunction in PD in order to optimize treatment responses. Full article