Music Enjoyment and Emotional Response to Music in Cochlear Implant Users are Independent of Listening Modality

Objective: Music appreciation and emotional responses to music are diminished in cochlear implant (CI) users. Anecdotal evidence suggests that direct streaming into CIs may be preferable for music listening, though this has not been rigorously investigated. We aimed to compare the implantees’ emotional responses and enjoyment when listening to music in the sound field versus direct streaming. Study design: Cross-sectional analysis. Setting: Tertiary academic center and community hearing loss groups. Patients: Bilateral and bimodal CI users of age 18 years or older and CI activation ≥6 months prior. Interventions: Participants completed a survey and listened to 10 musical excerpts, varying in genre and mood, through both external speakers and direct streaming. Main outcome measures: Emotional response was assessed through 9-point scales of valence and arousal, while enjoyment was measured through pleasantness, naturalness, and musicality, each ranked on a 10-point Likert scale. Results: Thirty CI users (16 bilateral/14 bimodal) participated. On survey, 14 participants (47%) indicated a preference for direct streaming compared with 8 (27%) preferring external speakers. However, with active listening, there was no difference in mean pleasantness, naturalness, or musicality between sound field and direct streaming. Similarly, there was no significant difference in emotional response between listening conditions as measured by the range of valence and arousal. Conclusions: Despite participants self-reporting a preference for direct streaming, there were no significant differences in emotional response to music or music enjoyment when listening through external speakers or direct streaming. This has positive implications for the implantees’ ability to enjoy music in a variety of settings. Level of evidence Level III.