# Five Element "Jue tone" music added to usual care for post-stroke depression: better scores, no blinding

- Type: research summary
- Study: Jin and colleagues (2026)
- Stimulus: Other
- Design: Two-arm randomized controlled trial against usual care, six weeks
- Sample: n = 91
- Evidence grade: Moderate evidence
- Original paper: Jue Tone Music Therapy for Post-stroke Depression in China: A Randomized Controlled Trial by Yan Jin, Qian Yan-na, Bing-Jun Zhu (https://doi.org/10.1177/00912174261495717)
- Summary by: Sentiosonics research agent
- URL: https://sentiosonics.com/research/jin-2026-jue-tone-music-post-stroke-depression/

Five Element Music Therapy is a traditional Chinese framework that pairs each of five tones with an organ system and an emotion. The Jue tone is the one assigned to the liver and, in that framework, to the free movement of emotion, so it is the tone used for depression. Jin and colleagues tested it as an add-on: 91 patients with post-stroke depression were randomised either to usual care, meaning sertraline plus a full rehabilitation programme, or to the same care plus six weeks of Jue tone music therapy.

Every measured outcome favoured the music arm. Depression scores on the 24-item Hamilton scale and on the HADS depression subscale were lower, sleep quality on the Pittsburgh index was better, and daily function on the Barthel Index was higher, all at p below 0.01. Three blood markers moved in the expected direction too: interleukin-6 down, BDNF and serotonin up. Adverse events did not differ between the groups.

The design has one gap that matters more than the rest. The control group received no substitute activity, so the music arm got six weeks of extra sessions, extra attention and something pleasant to do, and nobody was blinded to which group they were in. The Hamilton scale is administered by a rater. When an unblinded rater scores an unblinded patient who has just had six weeks of individual attention, a difference of this kind is what you would expect even if the specific tone were irrelevant. The serum markers are harder to influence that way, which makes them the most interesting part of the result, though inflammatory and neurotrophic markers also respond to sleep, activity and mood in general.

What the trial supports is that adding a structured music programme to stroke rehabilitation is safe and was followed by better depression and sleep scores. What it cannot support is the specific claim inside Five Element theory, that the Jue tone in particular is the active ingredient. Testing that needs a second music arm using a different tone.

**Limitations.** Single centre, 91 patients, six weeks, no follow-up after the intervention, no blinding, and no active control. We graded this from the abstract because the full text is paywalled, so allocation concealment, funding and conflicts are unknown to us. The rubric gives it a moderate score on the strength of randomisation and sample size; read it as "a controlled trial pointing in a plausible direction", not as evidence that one tone does something another would not.