Early Deafened, Late Implanted Cochlear Implant Users Appreciate Music More Than and Identify Music as Well as Postlingual Users

Abstract

Introduction: Typical cochlear implant (CI) users, namely postlingually deafened and implanted, report to not enjoy listening to music, and find it difficult to perceive music. Another group of CI users, the early-deafened (during language acquisition) and late-implanted (after a long period of auditory deprivation; EDLI), report a higher music appreciation, but is this related to a better music perception?Materials and Methods: Sixteen EDLI and fifteen postlingually deafened (control group) CI users participated in the study. The inclusion criteria for EDLI were: severe or profound hearing loss onset before the age of 6 years, implantation after the age of 16 years, and CI experience more than 1 year. Subjectively, music perception and appreciation was evaluated using the Dutch Musical Background Questionnaire. Behaviorally, music perception was measured with melodic contour identification (MCI), using two instruments (piano and organ), each tested with and without a masking contour. Semitone distance between successive tones of the target varied from 1 to 3 semitones.Results: Subjectively, the EDLI group reported to appreciate music more than postlingually deafened CI users. Behaviorally, while clinical phoneme recognition test score on average was lower in the EDLI group, melodic contour identification did not significantly differ between the two groups. There was, however, an effect of instrument and masker for both groups; the piano was the best-recognized instrument, and for both instruments, the masker with non-overlapping pitch was best recognized.Discussion: EDLI group reported higher appreciation of music than postlingual control group, even though behaviorally measured music perception did not differ significantly between the two groups. Both surprising findings since EDLI CI users would be expected to have lower outcomes based on the early deafness onset, long duration of auditory deprivation, and on average lower clinical speech scores. Perhaps, the music perception difficulty comes from similar electric hearing limitations in both groups. The higher subjective appreciation in EDLI might be due to the lack of a musical memory, with no ability to compare music heard via the CI to acoustic music perception. Overall, our findings support a benefit from implantation for a positive music experience in EDLI CI users.

Rapid Assessment of Non-Verbal Auditory Perception in Normal-Hearing Participants and Cochlear Implant Users

“…Overall, it appears that when the task is not purely pitch-perception centered, CI users can perform as well as NH participants. This could explain why, despite their poor pitch discrimination abilities, CI users are able to listen to and enjoy music [ 29 , 104 ]. It might be argued that the patients only succeeded because they were not impaired severely enough.…”

“…Some studies showed different arousal scores, but there were similar valence scores in CI users compared to NH listeners [ 8 , 25 ], suggesting that the musical emotion processing deficit is not a general deficit of music perception. Despite these limitations, some CI users still enjoy music, and have a strong desire to enhance this pleasure of music listening [ 29 , 30 ]. Overall, these results suggest that musical emotion recognition is possible in CI, but depends on features of the implantation as well as of the patient him/herself [ 31 ].…”

“…Overall, these results suggest that musical emotion recognition is possible in CI, but depends on features of the implantation as well as of the patient him/herself [ 31 ]. Music processing and appreciation might depend on the time of deafness and implantation: post-lingually deafened and implanted patients complain more about music depreciation compared to early-deafened late-implanted patients or prelingually implanted children [ 29 ]. Furthermore, some studies suggest that CI users might have implicit processing of pitch that could help them to enjoy music [ 32 ].…”

“…Overall, studies of music perception report that music appreciation remains poor in CI users [ 8 , 16 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Even if it might depend on previous musical knowledge [ 31 ], music perception—especially relating to pitch [ 24 , 33 ]—could possibly still be improved with CIs despite the technical limitations thanks to implicit knowledge related to pitch [ 29 , 32 ].…”

Self-reported music perception is related to quality of life and self-reported hearing abilities in cochlear implant users

“…The numbers of participants (n) for specific sections will be indicated explicitly in text, figures, and table, as not all 98 participants filled all sections of all questionnaires. The results of parts of the DMBQ with our study population have been published before, see Fuller et al (2012Fuller et al ( , 2013Fuller et al ( , 2019.…”