Background Music During Attention Testing in Parkinson’s Disease: Differential Effects on Mood and Attentional Networks

Background: Background music has been shown to influence cognitive performance and mood in healthy individuals, but evidence in clinical populations such as Parkinson’s disease (PD) remains scarce. In PD, attentional deficits and mood disturbances often co-occur, and both are closely linked to alterations in arousal regulation. Objective: This study investigated whether background music differing in arousal level modulates mood and attentional performance in individuals with PD and whether interindividual differences in music reward sensitivity influence these effects. Methods: Forty-one patients with mild to moderate PD completed the Attention Network Test (ANT) under three auditory conditions: moderate-low arousal music, moderate-high arousal music, and silence. Mood was assessed before and after the task using the Profile of Mood States (POMS), and individual differences were measured with the extended Barcelona Music Reward Questionnaire (eBMRQ). Results: Both music conditions reduced post-task depression compared to silence, but a significant pre–post improvement was observed only in the moderate-low arousal group. Fatigue was attenuated and tension decreased under low arousal music, whereas Vigor remained unchanged. Although overall ANT performance was unaffected by auditory condition, a block-wise analysis revealed that executive control improved over time in the low arousal group but declined in silence, while alerting increased only in the silence group. Furthermore, in the low arousal group, Mood Regulation scores from the eBMRQ positively predicted task accuracy. Conclusion: These findings suggest that low-arousal background music can support mood stabilization and sustain executive control in PD, particularly in patients who habitually use music for emotional regulation. The results highlight the importance of considering arousal level and individual differences when designing music-based cognitive interventions for clinical populations.