What is Interactive Metronome Therapy?

What is Interactive Metronome Therapy

You’ve heard of your body’s inner clock, but did you know that the brain has an internal clock too? Your brain’s ability to keep time is critical for the billions and billions of neurons in your head to be able to communicate effectively. And that’s the foundation for everything you do in your life—the way you think, the way you feel, the way you move.

In some people, that inner clock gets out of sync and doesn’t work at the proper tempo. Think of it like when you’re watching a movie and you can see the actor’s lips moving, but they aren’t in sync with what you’re hearing. It kind of drives you crazy, right? When your brain’s internal timing mechanism isn’t working properly, it can impact myriad daily functions and cause problems with:

  • Focus
  • Concentration
  • Impulsivity
  • Organization
  • Anxiety
  • Motivation
  • Thinking
  • Coordination
  • Motor tics
  • Neurological issues

Science shows that rhythm and timing is a baseline brain function. A unique therapy called Interactive Metronome training helps reset the timing in the brain at the millisecond level. “If you can straighten that out, then a lot of other brain functions start to follow in place,” says Mary Schlesinger, an Interactive Metronome trainer at Amen Clinics who has been using the therapy for 15 years.

What is Interactive Metronome® Training?

IM training is a non-invasive therapy that is used for many cognitive and neurological conditions, including:

It is also used for other conditions, such as ALS, multiple sclerosis, Parkinson’s disease, balance/gait disorders, and fine/gross motor problems. Some individuals go through IM training in order to enhance performance at work or school or in sports.

How Does Interactive Metronome® Work?

“If you were to watch me work with somebody, it wouldn’t really look like there’s that much going on,” says Schlesinger. Basically, people wear headphones and hold a sensor in one or both hands while they sit in front of a computer screen listening to a metronome. Each time they hear the metronome they tap the sensor and the computer measures their performance to 2/1000th of a second. On the screen, they see feedback that tells them if they’re a little bit off the beat and by how much so they can correct it.

It may not seem like much, but inside the brain, there’s a lot going on. “With every tap, the brain has to take in the information and plan, sequence, and execute the muscle movement,” says Schlesinger. When you put the audio, visual, and movement all together, she says, “You’re creating neural connections, and you’re getting them to the point where they’re hard-wired.”

What are the Benefits of Interactive Metronome® Training?

“What I typically see is improved concentration, initiative, organization, self-regulation, working memory, and executive function,” says Schlesinger. “I’ve had patients say they feel less anxious and can fall asleep and stay asleep better. I see confidence improve, which makes sense once you nail down concentration, impulse control, organization, and so on.” Other benefits Schlesinger has noted in her patients include faster visual processing and auditory processing, as well as improved athletic performance.

Schlesinger has seen IM training have remarkable results on adolescents, teens, and adults with ADD/ADHD. For example, she trained one sixth-grader diagnosed with ADHD named Emma. “She was making good grades, but it was thanks to sheer determination, an Individualized Education Plan (IEP), and medication,” says Schlesinger.

Emma was on adult levels of ADHD medications and could barely get through the school day. By the time she got home, she had to take more medication to do her homework, and then every night she ended up taking melatonin to help her fall asleep. Then the cycle started all over again. Emma’s mom was getting worried about the unhealthy cycle, but the doctor said there was nothing else he could give Emma.

At the end of 6th grade, Emma’s mother decided to take her daughter off of all her medications. “It’s summer. It doesn’t matter if she’s bouncy,” she thought.

Over a 49-day period that summer, Emma engaged in IM training with Schlesinger and made great progress. When Emma started junior high at the end of the summer, her mother decided not to put her back on the meds and braced herself for a barrage of phone calls from the girl’s teachers. She was used to getting a lot of calls about Emma’s behavior. “But she didn’t get any calls,” says Schlesinger. “And when the mom met with the teachers to go over Emma’s IEP plan, the teachers said, ‘We don’t really know why she’s on an IEP. She doesn’t need to be on an IEP.’”

Emma was able to get off her medications, no longer needed an IEP, and didn’t have to work so hard to do well in school.

Interactive Metronome® Training in the Brain

Multiple fMRI studies show that IM training leads to changes in several brain regions, including the cerebellum, prefrontal cortex (PFC), basal ganglia, and cingulate gyrus. The cerebellum (Latin for “little brain”), is involved with motor coordination and thought coordination and is essential for processing complex information. The PFC is responsible for impulse control, focus, and organization. The basal ganglia play an important role in integrating feeling and movement, as well as setting the body’s anxiety levels. The cingulate gyrus is involved in cognitive flexibility.

Before-and-after brain SPECT imaging studies on a patient name Jerry show how powerful IM training can be. Jerry had ADHD, anxiety, depression, memory loss, and other issues. As he went through the IM training process, he kept a journal about his progress, noting better motivation, improved ability to complete tasks, and better moods. Jerry’s follow-up brain scans showed improved brain health in areas related to ADHD, anxiety, depression, and other issues.

If you’re struggling with ADD/ADHD, anxiety, depression, memory problems, or other issues and are looking for alternatives or adjuncts to medication, it’s time to consider Interactive Metronome training at Amen Clinics with trainer Mary Schlesinger. IM training is available in-person or via IM-Home.

Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.


  1. How much does this training take with Mary Schlesinger? I have grandchildren who could benefit.

    Comment by Claudette McLennan — November 23, 2020 @ 9:56 AM

  2. Hello, thank you very much for sharing this information with the public. Do you by chance have any additional information that you would be willing to share via email for those without insurance or ease of accessibility? I am looking to implement and share this for others suffering in their general day to day, perhaps as background noise and plan to compile various articles to better share this therapy practice. I am only in the preliminary stages of conducting research and as such have only gotten so far on my own accord. The current question I have is what bpm you would recommended for certain conditions ie forty bpm for example for general anxiety and subsequent muscle spasms would be my guess but I have yet to see a chart written out as such.. I feel that this message and posting is not as well known or shared as it could be! Thank you for your time, best regards. -Erica

    Comment by Erica de Korver — May 1, 2023 @ 12:49 PM

  3. Hello Erica, thank you for reaching out. For more information about Interactive Metronome Training, please contact Amen Clinics Washington D.C.: https://www.amenclinics.com/locations/washington-dc-metro-area/.

    Comment by Amen Clinics — May 19, 2023 @ 10:47 AM

  4. So I have a neurological problem nobody seems to know what’s going on. I just had four vertebrae fused because of some other stuff but I was watching a movie and I hit a metronome and I read that so I’m real curious about it.

    Comment by Brian — October 17, 2023 @ 7:41 PM

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