Music-4-MS to Improve Cognition and Psychosocial Well-Being in People Living With Multiple Sclerosis: A Randomized Controlled Feasibility Study

Background: Multiple sclerosis (MS) affects over 2.8 million people worldwide, and up to 70% of people with MS experience cognitive impairment. Unlike conventional cognitive rehabilitation, music offers a complex, multidomain stimulus activating bilateral brain networks involved in cognitive, verbal, motor, and emotional processes. This study evaluated the feasibility and preliminary efficacy of Music-4-MS, an online music-learning intervention, in people with MS. Methods: A randomized controlled trial of 29 people with MS randomly assigned them to the Music-4-MS intervention (n = 16) or a music-listening active control (n = 13). Feasibility data were collected, and semistructured interviews assessed acceptability. Outcomes measured at baseline (T1), immediately after the intervention (T2), and 1 month after the intervention (T3) assessed psychosocial and functional well-being and cognitive performance on neuropsychological tests. Descriptive statistics summarized feasibility metrics, whereas content analysis examined qualitative data. Analysis of covariance compared T2 and T3 scores between groups, controlling for baseline values. Results: Participants who completed the study (79%) demonstrated high adherence and acceptability. Acceptability data revealed 6 themes: emotional resonance, navigating challenges, fostering connection and meaning, fluctuating motivation, adaptive learning strategies, and future recommendations. At T2, the Music-4-MS group exhibited lower anxiety and depression scores compared with controls (P < .01). At T3, intervention participants outperformed controls on the Trail Making Test Part B, with moderate to large effect sizes for most cognitive and some psychosocial outcomes. Conclusions: Music-4-MS was acceptable to participants and showed partial feasibility. Preliminary evidence suggests Music-4-MS has the potential to improve psychosocial well-being and cognitive functioning.