A primary auditory cortex-anterior cingulate cortex circuit underlying cross-modal visceral pain modulation.

Visceral pain represents an unmet clinical need due to the lack of safe and generalizable therapies. Given the analgesic potential of music and the underlying crosstalk between auditory and nociceptive pathways, this study aims to delineate the neural circuits interfacing auditory processing and visceral pain modulation. Using a mouse model of early-life stress, we identify a cortico-cortical circuit linking the primary auditory cortex (Au1) to the anterior cingulate cortex (ACC) that mediates stress-induced visceral pain. Mechanistically, early-life stress suppresses the activity of Au1 inhibitory (GABAergic, Au1(GABA)) neurons, which disinhibits downstream ACC excitatory (glutamatergic, ACC(Glu)) neurons, thereby driving visceral hypersensitivity. Notably, music intervention alleviates visceral pain by restoring Au1(GABA) neuronal activity and suppressing ACC(Glu) activity. In conclusion, this study unveils the Au1-ACC circuit as a critical hub for stress-induced visceral hypersensitivity and music-induced analgesia, providing a mechanistic foundation for clinical translation of music therapy in visceral pain management.