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The convergence of music and medicine is a fertile ground for innovative therapeutic interventions, now that the evidence base for how music can impact health has matured. Music-based interventions (MBIs) are not only effective in improving psychological wellbeing but also exert measurable physiological and neurological effects. Our call for papers for a special issue titled 'Music and Medicine: From Basic Science to Clinical Practice' resulted in this research topic published in Frontiers in Neuroscience: Auditory Cognitive Neuroscience. We sought contributions from researchers studying the basic science of music, clinical applications of music-based interventions and theoretical models. This editorial distills the core themes, mechanisms, and clinical applications that emerged across the peer-reviewed collection of articles. The present Frontiers Research Topic and eBook underscore the breadth of music's influence via a peer-reviewed collection of 16 articles describing music processing as an underlying neural mechanism with implications for clinical treatment, as a structured therapeutic tool for neurological diseases and cancer, and as a stimulus for emotional, cognitive and psychological health.Across these contributions, a coherent mechanistic framework emerges linking music's neural substrates to clinical outcomes. At the sensorimotor level, rhythmic auditory stimulation engages the sensorimotor cortex, supplementary motor area, and putamen through parallel cerebello-thalamo-cortical and striato-pallido-thalamocortical pathways, facilitating movement rehabilitation in Parkinson's disease (Harrison et al.) and informing how individual differences in motor and cognitive abilities predict synchronization success (Mudarris et al.). At the memory and default mode network level, familiar music activates the parahippocampal gyrus and medial prefrontal cortex, supporting autobiographical memory retrieval with implications for cognitive aging and early Alzheimer's intervention (Lesiuk et al.). Whole-brain network flexibility-the dynamic reorganization of functional communities-emerges as a key moderator: individuals with greater baseline flexibility derive stronger cognitive benefits from music creativity interventions (Wu-Chung et al.) Table 1. Neural systems mapped to measures and outcomes in this Special Topic.Key themes that emerged are:A foundational theme is the importance of rigorously defining both the intervention, its putative mechanisms, and the measurable outcomes that can serve to assess it (Hanson-Abromeit). Rhythmic auditory stimulation supports movement (re-)learning and attentional orienting. Individual differences in cognitive and motor abilities affect the efficacy of music-based sensorimotor synchronization, emphasizing the need to tailor interventions to baseline abilities (Mudarris et al.).Five-tone therapy is explored for its analgesic effects, with music stimulation modulating nerve oscillations in brain regions associated with the "pain matrix." This approach offers new directions for pain management by leveraging music's ability to regulate neural mechanisms (Tan et al.). The role of MBIs in pain management is an active area of current research, with significant funding from the NIH to spearhead collaborative networks of clinicians, researchers and practitioners.Parkinson's Disease Music mindfulness, which combines music listening with mindfulness activities, acutely enhances heart rate variability and alters neural activity, effectively targeting the autonomic nervous system and brain networks involved in goal-directed behavior and emotional regulation. These effects are beneficial for treating symptoms of anxiety and depression, with live sessions also increasing social connection (Rameriz et al.)Taken together, these reports collectively demonstrate that music is a multifaceted therapeutic agent in medicine, with applications ranging from mental health and neurological rehabilitation to cardiovascular and oncological care. Its efficacy is supported by neurobiological, physiological, and psychological evidence, and its integration into clinical practice is guided by evolving scientific standards, including careful monitoring at the level of the individual, and, when appropriate, personalization of the intervention. Music's ability to engage brain networks, regulate emotion, and foster resilience underscores its value as both a preventive and rehabilitative tool in modern healthcare, Special topics like this one that bring together a diverse set of findings enable researchers to build mechanistic frameworks that will lead to more efficient translation in the hands of practitioners.