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CHAPTER 05 · The Neurobiology of Creativity

How Tempo, Harmony, Melody, and Rhythm Affect the Autonomic Nervous System

Kamal R. Chémali, MD

ABOUT THE AUTHORS

Abstract

This chapter explores the impact of different musical elements, such as tempo, harmony, melody, and rhythm, on the autonomic nervous system (ANS). It discusses how faster tempos tend to increase sympathetic activity, while slower tempos enhance parasympathetic activity. Consonant harmonies induce calmness, while dissonant harmonies can trigger stress responses. Melody, though complex and subjective, has been linked to emotional engagement and physiological reactions like increased heart rate variability in infants exposed to maternal singing. Rhythm closely interacts with the body's natural functions, facilitating synchronization that can influence motor responses and emotional states. The author presents personal experiences and studies, illustrating the effects of these musical elements on specific ANS parameters, such as heart rate, blood pressure, and pupillary responses. The chapter emphasizes the importance of understanding these relationships to maximize the therapeutic potential of music in clinical settings, tailoring music-based interventions to individual needs. It also highlights gaps in knowledge and the need for further research, particularly on the neural pathways involved in the music-emotion- ANS interaction.

Keywords

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Chapter references below omit unverified page ranges and chapter-specific DOIs.

APA

Chémali, K. R. (2026). How Tempo, Harmony, Melody, and Rhythm Affect the Autonomic Nervous System. In P. L. Pearl & S. Arfaie (Eds.), Music, Medicine, and the Neurobiology of Creativity. Cambridge University Press.

AMA

Chémali KR. How Tempo, Harmony, Melody, and Rhythm Affect the Autonomic Nervous System. In: Pearl PL, Arfaie S, eds. Music, Medicine, and the Neurobiology of Creativity. Cambridge University Press; 2026.

Vancouver

Chémali KR. How Tempo, Harmony, Melody, and Rhythm Affect the Autonomic Nervous System. In: Pearl PL, Arfaie S, editors. Music, Medicine, and the Neurobiology of Creativity. Cambridge: Cambridge University Press; 2026.

Chicago

Chémali, Kamal R.. “How Tempo, Harmony, Melody, and Rhythm Affect the Autonomic Nervous System.” In Music, Medicine, and the Neurobiology of Creativity, edited by Phillip L. Pearl and Saman Arfaie. Cambridge University Press, 2026.

BibTeX

@incollection{chapter5_2026,
  author = {Chémali, Kamal R},
  title = {How Tempo, Harmony, Melody, and Rhythm Affect the Autonomic Nervous System},
  booktitle = {Music, Medicine, and the Neurobiology of Creativity},
  editor = {Pearl, Phillip L. and Arfaie, Saman},
  publisher = {Cambridge University Press},
  year = {2026}
}

Harvard

Chémali, K. R. (2026) “How Tempo, Harmony, Melody, and Rhythm Affect the Autonomic Nervous System”, in Pearl, P.L. and Arfaie, S. (eds.) Music, Medicine, and the Neurobiology of Creativity. Cambridge: Cambridge University Press.

Kamal R. Chémali

Kamal R. Chémali

MD

Professor of Neurology; Director, Autonomic Program and Laboratories; Medical Director, Music and Medicine Program

Case Western Reserve University · University Hospitals Cleveland Medical Center

Profile

Kamal R. Chémali is a Professor of Neurology at Case Western Reserve University and directs the Autonomic Program and Laboratories and the Music and Medicine Program at University Hospitals Cleveland Medical Center. His chapter examines how tempo, harmony, melody, and rhythm affect the autonomic nervous system, placing musical experience in the context of physiological regulation.

Scholarship & professional background

A conservatory-trained pianist who began studying music in childhood, he has developed a parallel career connecting performance with neurological care. His clinical interests in autonomic disorders inform his work on the physiological effects of music, including the relationship between musical experience and bodily regulation. At University Hospitals, his activities in music and medicine also address medical problems affecting musicians.

Selected work & perspectives

Academic profile and professional workMusic-related medical care · University HospitalsMusic and autonomic medicine · Interview with Kamal Chémali