Neural Activations of Guided Imagery and Music in Negative Emotional Processing: A Functional MRI Study

Background: The Bonny Method of Guided Imagery and Music uses music and imagery to access and explore personal emotions associated with episodic memories. Understanding the neural mechanism of guided imagery and music (GIM) as combined stimuli for emotional processing informs clinical application. Objective: We performed functional magnetic resonance imaging (fMRI) to demonstrate neural mechanisms of GIM for negative emotional processing when personal episodic memory is recalled and re-experienced through GIM processes. Methods: Twenty-four healthy volunteers participated in the study, which used classical music and verbal instruction stimuli to evoke negative emotions. To analyze the neural mechanism, activated regions associated with negative emotional and episodic memory processing were extracted by conducting volume analyses for the contrast between GIM and guided imagery (GI) or music (M). Results: The GIM stimuli showed increased activation over the M-only stimuli in five neural regions associated with negative emotional and episodic memory processing, including the left amygdala, left anterior cingulate gyrus, left insula, bilateral culmen, and left angular gyrus (AG). Compared with GI alone, GIM showed increased activation in three regions associated with episodic memory processing in the emotional context, including the right posterior cingulate gyrus, bilateral parahippocampal gyrus, and AG. No neural regions related to negative emotional and episodic memory processing showed more activation for M and GI than for GIM. Conclusions: As a combined multimodal stimulus, GIM may increase neural activations related to negative emotions and episodic memory processing. Findings suggest a neural basis for GIM with personal episodic memories affecting cortical and subcortical structures and functions.