683: Non-nociceptive Activity Mediating the Effects of Music on Pain

Topic: Experimental (Non-clinical) Human Studies
Subtopic: Non -specific to any diagnosis, Psychology, Imaging (e.g. fMRI, PET, MRS)

Background and Aims: Listening to music effectively relieves pain and reduces patients need for analgesics, but the underlying mechanisms of this effect are not well understood. However, music that is considered pleasant, favorite, and preferred is the most effective (1,2). These results suggest the mediating involvement of evaluative and reward processes in the brain in response to music (3). The aims of this study were to 1. Investigate the hypoalgesic role of reward in an fMRI task paradigm through a series of mediation path models 2. Link the effects of music to other pain modulatory processes by assessing changes in expression of pain neurosignatures.

Methods: 63 healthy participants completed a within-subject repeated measures fMRI task where they listened to self-selected music, scrambled music, and silence in the scanner. Each excerpt was presented once without pain, and once paired with a volley of 4*8sec painful thermal stimulations. Ratings of thermal pain and musical enjoyment were inputted into hierarchical path models to assess the mediating effect of subjective pleasure. Brain activity during stimulations was then inputted into a voxel search for mediators in the grey matter, as well as in a meta-analytic mask of reward regions (4,5). Pattern expression of pain neurosignatures (6,7) was compared within subjects.

Results: Music reduced subjective pain report compared to controls (Music Vs. Silence: β=-.29, p< .001. Music Vs. Scrambled: β=-.19, p< .001) , and this effect was completely mediated by pleasure ratings given in the scanner (β ab: -.37, p >.05). The voxel searches for mediators revealed significant mediating activity in the vmPFC and dACC at pFDR>.05. Expression of the Stimulus Intensity Independent Signature predicting pain report beyond nociception was significantly reduced by music (Music Vs. Silence: t(62) = -2.79, p< .001. Music Vs. Scrambled: t(62) =-2.68, p< .001), and mediated the effects of Music Vs. Silence on pain ratings (β=-.26, p< .05).

Conclusions: Our results are novel in linking changes in brain activity resulting from the experimental manipulation (Music vs controls) to changes in pain report. We show that the effects of music on pain recruit non-nociceptive brain activity associated with musical reward and the affective experience of pain, providing neuroimaging evidence for a consistent behavioral effect observed in previous studies.

References: 1. Lee JH. The Effects of Music on Pain: A Meta-Analysis. J Music Ther. 2016 Winter;53(4):430-477. doi: 10.1093/jmt/thw012. Epub 2016 Oct 19. Erratum in: J Music Ther. 2021 Aug 24;58(3):372. doi: 10.1093/jmt/thab012. PMID: 27760797. 2. Garza-Villarreal EA, Pando V, Vuust P, Parsons C. Music-Induced Analgesia in Chronic Pain Conditions: A Systematic Review and Meta-Analysis. Pain Physician. 2017 Nov;20(7):597-610. PMID: 29149141. 3. Zatorre, R.J. (2015), Musical pleasure and reward: mechanisms and dysfunction. Ann. N.Y. Acad. Sci., 1337: 202-211. https://doi.org/10.1111/nyas.12677. 4. Tor Wager (2026). MediationToolbox (https://github.com/canlab/MediationToolbox), GitHub. 5. Mas-Herrero E, Maini L, Sescousse G, Zatorre RJ. Common and distinct neural correlates of music and food-induced pleasure: A coordinate-based meta-analysis of neuroimaging studies. Neurosci Biobehav Rev. 2021 Apr;123:61-71. doi: 10.1016/j.neubiorev.2020.12.008. Epub 2021 Jan 10. PMID: 33440196. 6. Wager, T. D., Atlas, L. Y., Lindquist, M. A., Roy, M., Woo, C.-W., & Kross, E. (2013). An fMRI-based neurologic signature of physical pain. The New England Journal of Medicine, 368(15), 1388–1397. https://doi.org/10.1056/NEJMoa1204471. 7. Woo, C.-W., Schmidt, L., Krishnan, A., Jepma, M., Roy, M., Lindquist, M. A., Atlas, L. Y., & Wager, T. D. (2017). Quantifying cerebral contributions to pain beyond nociception. Nature Communications, 8, 14211. https://doi.org/10.1038/ncomms14211

Presenting Author: Elise Desbarats
Submitting Author: Elise Desbarats

Senior Author: Mathieu Roy

IASP 2026 Global Year theme of Neuropathic Pain: No

• Eui-Jin Jung: BA - IBS Center for Neuroscience Imaging Research, Sungkungkwan University, South Korea
• Robert J Zatorre: PhD - Montreal Neurological Institute, McGill University, Canada
• Alain Dagher: PhD - Montreal Neurological Institute, McGill University, Canada
• Choong-wan Woo: PhD - IBS Center for Neuroscience Imaging Research, Sungkungkwan University, South Korea
• Mathieu Roy: PhD - Department of Psychology, McGill University, Canada