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ObjectiveThis meta-analysis aimed to evaluate the effects of art-based interventions on non-motor symptoms among individuals with Parkinson's disease.MethodRCTs published between 1990 and September 30, 2025, were identified through searches in PubMed, Embase, Web of Science, and the Cochrane Library. Data extraction and quality assessment followed PRISMA guidelines using the Cochrane RoB 2.0 tool. Meta-analyses were conducted in R, with primary outcomes synthesized using forest and funnel plots, subgroup analyses, leave-one-out analysis and prediction intervals.ResultsA total of 22 studies involving 928 participants were included. Art-based interventions produced a significant improvement in fear of falling and activity-related confidence (FES: SMD = -0.41; 95% CI [-0.67, -0.15]; p I 2 = 3.8%), with subgroup analyses showing a moderate effect for music interventions. The prediction interval excluded the null (95% PI [-0.78, -0.04]), indicating that the effect was relatively consistent across studies. Art-based interventions showed a small, non-significant effect on quality of life (PDQ-39: SMD = -0.19, 95% CI [-0.39, 0.01], p > 0.05). Subgroup analyses indicated that combined music and dance-music interventions yielded the strongest point estimates and reached statistical significance, although these findings were derived from single studies. Theater and dance interventions did not reach statistical significance for quality-of-life outcomes. No significant improvements were observed in cognitive function (MoCA: SMD = 0.05; 95% CI [-0.19, 0.30]; p > 0.05), and depressive symptoms showed only a small, non-significant reduction (BDI: SMD = -0.23; 95% CI [-0.63, 0.18]; p > 0.05).ConclusionArt-based interventions showed selective benefits for non-motor symptoms in Parkinson's disease, with significant reductions in fear of falling, especially in music-based approaches. Effects on quality of life were small and non-significant, and no clear improvements were found for cognition or depression. Larger trials are needed to confirm clinical relevance.Systematic review registrationIdentifier: CRD42025633292.
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