The Effects of Low-Intensity Music in Adolescents With Anxiety

The Effects of Low-Intensity Music on Brain-Heart Function in Adolescents With Anxiety

In modern society, increasing attention has been devoted to mental health problems among adolescents, with anxiety and depressive disorders being particularly prevalent in this population. Evidence indicates that anxiety not only affects emotional states and daily quality of life but also has significant impacts on physiological health, including blood pressure and heart rate. At present, clinical treatment relies primarily on pharmacological interventions and cognitive behavioral therapy; however, these approaches are associated with limitations such as pronounced side effects and delayed onset of efficacy, which restrict their applicability in adolescents. Music and other structured sounds have been used since ancient times to alleviate negative emotional states such as tension and anxiety. Research has shown that listening to soothing music can reduce sympathetic nervous system activity while enhancing parasympathetic tone, thereby leading to a decrease in heart rate and an increase in heart rate variability (HRV). Owing to its gentle characteristics, low-intensity soothing music is considered effective in relieving stress, regulating emotional states, and exerting beneficial effects on physiological indicators.

Study Overview

• Status: Recruiting
• Conditions: Anxiety
• Intervention / Treatment: Other: Low-Intensity Soothing Music; Behavioral: Environmental Sound Exposure

Detailed Description

In modern society, adolescent mental health problems have attracted increasing attention. Anxiety disorders, as one of the most representative manifestations, not only impair daily functioning and academic performance but may also exert profound effects on physiological health. In recent years, music therapy, as a non-pharmacological intervention, has demonstrated considerable potential in alleviating anxiety. The present study aims to investigate the effects of low-intensity soothing music on physiological indicators, including cerebral blood flow and heart rate, in adolescents experiencing anxiety episodes, using functional near-infrared spectroscopy (fNIRS). This research not only contributes to a deeper understanding of the mechanisms underlying music therapy but also provides a scientific basis for the development of more effective interventions for adolescent anxiety.

Using fNIRS, we will continuously monitor changes in cortical cerebral blood flow, as alterations in hemodynamic patterns can directly reflect the effects of music-based interventions. Heart rate, as another key physiological indicator, will be continuously recorded and analyzed throughout the experiment. By means of a wearable smart band, we will capture heart rate variability (HRV) as well as temporal trends in heart rate. These data will enable us to determine whether low-intensity soothing music can reduce heart rate levels and enhance autonomic nervous system balance in adolescents with anxiety. In addition, immediate changes in heart rate before and after music exposure will be evaluated to assess the short-term effects of the intervention.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Wang
• Study Contact Backup: Name: Yue Zhu, Phd; Phone Number: 86-18640197059; Email: zhuyuemiiu@163.com

Study Locations

• China
  • Hainan
    • Haikou, Hainan, China
      • Recruiting
      • Hainan Medical University
      • Contact: Lijuan Liang, Phd; Phone Number: 86-18640197059; Email: lianglijuan_2005@163.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Participants experiencing anxiety episodes were adolescents aged 18-25 years with a Generalized Anxiety Disorder-7 (GAD-7) score ≥ 5;
• Participants completed self-report symptom assessments via a digital mental health screening platform, alongside the collection of acoustic voice features, heart rate, and functional near-infrared spectroscopy (fNIRS) data;
• All participants were required to provide written informed consent;

Exclusion Criteria:

• History of major somatic illnesses, particularly those potentially associated with brain tissue alterations, such as hypertension, diabetes, or metastatic tumors; unstable physical conditions, including severe asthma; and a history of neurological abnormalities, including significant head trauma (loss of consciousness lasting more than five minutes), epilepsy, cerebrovascular disease, brain tumors, and neurodegenerative disorders;
• Somatic conditions that may induce mood disorder symptoms, such as multiple sclerosis or thyroid disorders;
• IQ below 70;
• Autism spectrum disorder (ASD) or pervasive developmental disorder (PDD);
• Participants with significant substance abuse or dependence within the three months preceding enrollment were excluded;
• Participants at high risk for suicide or with a prior history of suicide attempts were excluded;

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Music Stimulation Group; Participants in this group will listen to a pre-selected low-intensity music piece (Pachelbel's Canon in D major, Blenders) for approximately 14 minutes in total, with maximum volume 5 dB above ambient sound. Before the intervention, participants will sit quietly for 5 minutes to establish a baseline, complete self-report questionnaires, and undergo fNIRS and ECG measurements. During the intervention, participants remain silent and seated while cerebral hemodynamics (CBV) and heart rate variability (HRV) are continuously recorded. After the intervention, the same assessments and 5-minute resting recordings are repeated. This arm evaluates clinical response, physiological changes, and neuroimaging features associated with the music intervention.	Other: Low-Intensity Soothing Music; Participants will listen to pre-selected low-intensity soothing music under standardized experimental conditions. Anxiety symptoms, and depressive symptoms will be assessed before and after the intervention. In parallel, heart rate variability (HRV) and fNIRS will be recorded to evaluate the short-term clinical effects of the music intervention and to explore its potential neurophysiological mechanisms.
Experimental: Environmental Sound Control Group; Participants in this group will listen to recorded environmental sounds, matched to the music group in decibel level, for the same duration (~14 minutes). Baseline procedures, including 5 minutes of quiet sitting, self-report questionnaires, fNIRS, and ECG measurements, are identical to the music group. During the intervention, participants remain silent and seated while cerebral hemodynamics (CBV) and heart rate variability (HRV) are continuously recorded. After the intervention, the same assessments and 5-minute resting recordings are repeated.	Behavioral: Environmental Sound Exposure; Participants listen to recorded environmental sounds matched in decibel to the music group, for ~15 minutes. Baseline and post-intervention assessments are identical to the music group, including self-report questionnaires, fNIRS, and ECG recordings.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in anxiety symptoms assessed by the Generalized Anxiety Disorder-7 (GAD-7, range: 0-21) after the intervention.	The total scores of these questionnaires were interpreted as follows: normal (0-4), mild (5-9), moderate (10-14), and severe (15-21) anxiety.	Baseline and immediately after the intervention (Day 1)
Change baseline in anxiety symptoms assessed by the State - Trait Anxiety Inventory (STAI-T; range: 20-80) after the intervention.		Baseline and immediately after the intervention (Day 1)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in depressive symptoms assessed by the Patient Health Questionnaire-9 (PHQ-9; range: 0-27) after the intervention.	The total scores of these questionnaires were interpreted as follows: normal (0-4), mild (5-9), moderate (10-14), and severe (15-27) depression.	Baseline and immediately after the intervention (Day 1)
Change from baseline in the cerebral blood volume (CBV) measured by functional near-infrared spectroscopy(fNIRS) after the intervention.	Participants will undergo fNIRS scans prior to beginning music treatment (baseline) and after completing music treatment (after the intervention). CBV is a fNIRS indicator that reflects the alterations in cerebral blood flow.	During the intervention (Day 1)
Change from baseline in the heart rate variability (HRV) measured by wearable device after the intervention.	Participants will undergo wearable device prior to beginning music treatment (baseline) and after completing music treatment (after the intervention). HRV is a heart indicator that reflects the alterations in autonomic nervous system.	Baseline and immediately after the intervention (Day 1)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in perceived stress assessed by the Momentary assessment of emotional valence and arousal (range: 1-9) after the intervention.	Effects of the intervention on emotional valence (positive/negative) and arousal.	Baseline and immediately after the intervention (Day 1)

Collaborators and Investigators

• Sponsor: Jiangsu Province Nanjing Brain Hospital
• Investigators: Study Chair: Fei Wang, Nanjing Brain Hospital

Study record dates

Study Major Dates

• Study Start (Actual): December 15, 2025
• Primary Completion (Estimated): May 30, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: February 4, 2026
• First Submitted That Met QC Criteria: March 19, 2026
• First Posted (Actual): March 25, 2026

Study Record Updates

• Last Update Posted (Actual): March 25, 2026
• Last Update Submitted That Met QC Criteria: March 19, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Music Therapy
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: 81725005-13

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No