It takes experience to tango: Experienced cochlear implant users show cortical evoked potentials to naturalistic music

Approximately 30% of cochlear implant (CI) users report that restoring their ability to enjoy music is a primary goal. However, music perception in CI users has mostly been investigated in controlled laboratory settings using simplified stimuli, such as pure tones or monophonic melodies. There is an increasing interest in developing objective measures of CI outcomes in everyday listening situations, particularly in music listening, which involves complex stimuli rich in timbre, pitch, rhythm, and overlapping sounds. One promising approach is to measure cortical auditory evoked responses (ERs) in CI users. We investigated whether ERs to sound onsets in a naturalistic four-minute music piece could be measured in adult CI users (N: 25; ages 18-80; CI experience: 0.3-14 years). We assumed that the accumulation of CI experience might be reflected in the morphology of the ERs. The results confirmed that P2 responses to sound onsets embedded in a whole piece of music can be detected in experienced CI users. Compared to a control group with normal hearing, the CI users showed P2 responses with lower amplitudes and longer latencies. Exploratory linear regression models suggested that the logarithmic duration of CI experience significantly predicted both perceived quality of musical sounds and P2 amplitude, explaining 38% and 28% of the variance, respectively. The findings suggest that music perception outcomes may continue to improve for up to 2-4 years post-implantation. Altogether, the results are consistent with the use of ERs to track CI adaptation to music listening.