This study explores Clinically Designed Improvisatory Music (CDIM) feasibility in reducing anxiety in individuals with Alzheimer’s Disease (AD-A) and caregiver burden and modulating four brain networks crucial for emotional processing.

Fifteen individuals with AD-A and 12 caregivers participated in a delayed enrollment study with two pre- and one post-CDIM evaluation. CDIM involved eight 30-minute sessions of slow, meandering melodic improvisations delivered in 2-minute segments by a certified clinical music practitioner. Anxiety and caregiver burden were assessed using the Rating Anxiety in Dementia (RAID) and Zarit Burden Interview (ZBI), respectively. Vital signs (BP, RR, HR) were recorded. Functional MRI data were analyzed for connectivity changes in 4 brain networks: Default Mode Network (DMN), Salience Network (SN), Reward Network (RN), and Auditory Limbic Network (ALN) using the CONN toolbox.

Our findings indicate CDIM appears feasible for reducing anxiety and caregiver burden, with symptomatic, physiological, and neural effects. In the AD-A group, autonomic dysfunction or cholinesterase inhibitors may interfere with physiological evaluations. We believe CDIM transitions the autonomic and emotional networks to a calmer state through entrainment. fMRI findings suggest CDIM may modulate abnormal network connectivity, reducing anxiety. Recruitment and fMRI data collection are ongoing.