Publication Name	World Journal of Critical Care Medicine
Manuscript ID	116487
Country	Japan

Category	Emergency Medicine
Manuscript Type	Letter to the Editor
Article Title	Neurobiological rhythms in critical care: A commentary on intensive care unit music therapy efficacy and mechanism
Manuscript Source	Invited Manuscript
All Author List	Takahiko Nagamine
Funding Agency and Grant Number
Corresponding Author	Takahiko Nagamine, MD, PhD, Professor, Psychiatric Internal Medicine, Sunlight Brain Research Center, 4-13-18 Jiyugaoka, Hofu 7470066, Yamaguchi, Japan. anagamine@yahoo.co.jp
Key Words	Music therapy; Neuroplasticity; Intensive care unit; Critical care; Brain-derived neurotrophic factor; Anxiety
Core Tip	The single 30-minute music therapy session achieved remarkable results, including reduced patient anxiety, pain, and, crucially, lower intensive care unit (ICU) mortality (7.4% vs 19.1%) and a shorter ICU length of stay (4.97 days vs 5.70 days). To justify these powerful, long-term findings, the intervention must engage fundamental neurobiological pathways. Since structural brain changes and the upregulation of factors like brain-derived neurotrophic factor require sustained effort, the study's brief, one-time protocol and unblinded design introduce a major mechanistic conundrum. Future, rigorous trials with repeated sessions and credible sham controls are essential to prove that music's neurobiological power, and not just a strong attention effect, drives recovery in critically ill patients.
Citation	Nagamine T. Neurobiological rhythms in critical care: A commentary on intensive care unit music therapy efficacy and mechanism. World J Crit Care Med 2026; In press

Received	2025-11-13 04:47
Peer-Review Started	2025-11-13 04:47
First Decision by Editorial Office Director	2025-12-04 09:03
Return for Revision	2025-12-04 09:03
Revised	2025-12-05 00:11
Publication Fee Transferred
Second Decision by Editor	2026-01-07 02:41
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-01-07 06:52
Articles in Press	2026-01-07 06:52
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3141(online)
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