Vocal and musical emotion perception, voice cue discrimination, and quality of life in cochlear implant users with and without acoustic hearing

This study aims to provide a comprehensive picture of auditory emotion perception in cochlear implant (CI) users by (1) investigating emotion categorisation in both vocal (pseudo-speech) and musical domains and (2) how individual differences in residual acoustic hearing, sensitivity to voice cues (voice pitch, vocal tract length), and quality of life (QoL) might be associated with vocal emotion perception and, going a step further, also with musical emotion perception. In 28 adult CI users, with or without self-reported acoustic hearing, we showed that sensitivity (d') scores for emotion categorisation varied largely across the participants, in line with previous research. However, within participants, the d' scores for vocal and musical emotion categorisation were significantly correlated, indicating both similar processing of auditory emotional cues across the pseudo-speech and music domains as well as robustness of the tests. Only for musical emotion perception, emotion d' scores were higher in implant users with residual acoustic hearing compared to no acoustic hearing. The voice pitch perception did not significantly correlate with emotion categorisation in either domain, while the vocal tract length significantly correlated in both domains. For QoL, only the sub-domain of Speech production ability, but not the overall QoL scores, correlated with vocal emotion categorisation, partially supporting previous findings. Taken together, results indicate that auditory emotion perception is challenging for some CI users, possibly a consequence of how available the emotion-related cues are via electric hearing. Improving these cues, either via rehabilitation or training, may also help auditory emotion perception in CI users.