Towards a Neurobiological Model of Music in Psychedelic-Assisted Therapy: A Systematic Review

The rapid expansion of psychedelic research over the past decade reflects a convergence of regulatory easing, replicated evidence for clinical efficacy, and advances in modern neuroscience methods. Within this context, music—long treated as a contextual element of “set and setting”—has increasingly been reframed as an active modulator of emotional, cognitive, and neural processes during psychedelic experiences. To date, existing reviews have primarily taken narrative and scoping approaches, and no systematic review has evaluated this literature with respect to study design, methodological quality, and underlying neurobiological mechanisms. This systematic review will be the first to comprehensively synthesize experimental and clinical evidence on the neurobiological role of music in psychedelic-assisted therapy. While the primary focus is on neurobiological and clinically relevant mechanisms, we will additionally include studies that intentionally examine the role and impact of music on participants’ experiential processes using qualitative or mixed-methods approaches, insofar as these data help contextualize and interpret neurobiological and clinical findings. Adult studies in which music experience is explicitly manipulated or systematically examined during the administration of psychedelic compounds within therapeutic or experimental contexts, across healthy and clinical populations, will be included. Study designs will be classified a priori, and risk of bias will be assessed using design-appropriate tools, allowing conclusions regarding neurobiological mechanisms to be explicitly weighted by methodological rigor.