EXPRESS: 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 categorization in both vocal (pseud-ospeech) 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 categorization varied largely across the participants, in line with previous research. However, within participants, the d' scores for vocal and musical emotion categorization were significantly correlated, indicating similar processing of auditory emotional cues across the pseudo-speech and music domains and 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 categorization in either domain, while the vocal tract length significantly correlated in both domains. For QoL, only the subdomain of Sspeech production ability, but not the overall QoL scores, correlated with vocal emotion categorization, 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.