Dysregulation of the autonomic nervous system (ANS) and the hypo-
thalamic–pituitary–adrenal (HPA) axis has been implicated in psychiatric
disorders. Music therapy (MT) has been shown to modulate heart-rate
variability (HRV) and salivary stress markers, physiological markers of the
ANS and HP
A axes, respectively
. Given the prominent role of arousal

and stress physiology in many psychiatric disorders, MT has the poten
tial to provide therapeutic benefits in psychiatry. Active MT requires pa
tients to engage rhythmically with music; in contrast, passive MT requires
patients to listen to music, eliminating the rhythmic movement seen in
active MT
. Y
et, it remains unknown whether active or passive MT dif

ferentially modulates arousal and stress physiology. We contrasted the
effects of active and passive MT experiences to examine the differential
impact of rhythmic movement on the ANS and HP
A axes in healthy par

ticipants. Individuals (
= 16) participated in a crossover study of 40 min
of an active MT and a passive MT intervention. HRV recordings and
saliva samples were collected both before and after each intervention.
The high-frequency component (HF) and the ratio of low-frequency to
components (LF/HF) were calculated as cardiac markers

of parasympathetic and sympathetic ANS activation, respectively
. Saliva

samples were analyzed for alpha-amylase and cortisol, markers of the
ANS and
HPA axes, respectively
. Active MT and passive MT

interventions differen
tially modulated LF/HF
, where active MT decreased

LF/HF and passive MT increased LF/HF. These results indicate that MT
affects the ANS and suggests that differences in engagement between
active MT and passive MT lead to a differential modulation of the sym
pathetic ANS.