Age-Related Changes in Voice Emotion Recognition by Postlingually Deafened Listeners With Cochlear Implants

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.

Investigation of Deficits in Auditory Emotional Content Recognition by Adult Cochlear Implant Users through the Study of Electroencephalographic Gamma and Alpha Asymmetry and Alexithymia Assessment

BACKGROUND/OBJECTIVES

Given the importance of emotion recognition for communication purposes, and the impairment for such skill in CI users despite impressive language performances, the aim of the present study was to investigate the neural correlates of emotion recognition skills, apart from language, in adult unilateral CI (UCI) users during a music in noise (happy/sad) recognition task. Furthermore, asymmetry was investigated through electroencephalographic (EEG) rhythm, given the traditional concept of hemispheric lateralization for emotional processing, and the intrinsic asymmetry due to the clinical UCI condition.

METHODS

Twenty adult UCI users and eight normal hearing (NH) controls were recruited. EEG gamma and alpha band power was assessed as there is evidence of a relationship between gamma and emotional response and between alpha asymmetry and tendency to approach or withdraw from stimuli. The TAS-20 questionnaire (alexithymia) was completed by the participants.

RESULTS

The results showed no effect of background noise, while supporting that gamma activity related to emotion processing shows alterations in the UCI group compared to the NH group, and that these alterations are also modulated by the etiology of deafness. In particular, relative higher gamma activity in the CI side corresponds to positive processes, correlated with higher emotion recognition abilities, whereas gamma activity in the non-CI side may be related to positive processes inversely correlated with alexithymia and also inversely correlated with age; a correlation between TAS-20 scores and age was found only in the NH group.

CONCLUSIONS

EEG gamma activity appears to be fundamental to the processing of the emotional aspect of music and also to the psychocognitive emotion-related component in adults with CI.

Redefining Success in Adult Cochlear Implant Outcomes

This Viewpoint outlines both the need and recommendations for adopting a holistic, whole-person approach to assessing adult cochlear implant outcomes, which may aid clinicians in identifying rehabilitative targets to improve and optimize everyday functional outcomes.

Emotional prosody perception and production are linked in prelingually deaf children with cochlear implantsa)

Links between perception and production of emotional prosody by children with cochlear implants (CIs) have not been extensively explored. In this study, production and perception of emotional prosody were measured in 20 prelingually deaf school-age children with CIs. All were implanted by the age of 3, and most by 18 months. Emotion identification was well-predicted by prosody productions in terms of voice pitch modulation and duration. This finding supports the idea that in prelingually deaf children with CIs, production of emotional prosody is associated with access to auditory cues that support the perception of emotional prosody.

Predicting emotion perception abilities for cochlear implant users

OBJECTIVE

In daily life, failure to perceive emotional expressions can result in maladjusted behaviour. For cochlear implant users, perceiving emotional cues in sounds remains challenging, and the factors explaining the variability in patients' sensitivity to emotions are currently poorly understood. Understanding how these factors relate to auditory proficiency is a major challenge of cochlear implant research and is critical in addressing patients' limitations.

DESIGN

To fill this gap, we evaluated different auditory perception aspects in implant users (pitch discrimination, music processing and speech intelligibility) and correlated them to their performance in an emotion recognition task.

STUDY SAMPLE

Eighty-four adults (18-76 years old) participated in our investigation; 42 cochlear implant users and 42 controls. Cochlear implant users performed worse than their controls on all tasks, and emotion perception abilities were correlated to their age and their clinical outcome as measured in the speech intelligibility task.

RESULTS

As previously observed, emotion perception abilities declined with age (here by about 2-3% in a decade). Interestingly, even when emotional stimuli were musical, CI users' skills relied more on processes underlying speech intelligibility.

CONCLUSIONS

These results suggest that speech processing remains a clinical priority even when one is interested in affective skills.

Linking Affective and Hearing Sciences-Affective Audiology

A growing number of health-related sciences, including audiology, have increasingly recognized the importance of affective phenomena. However, in audiology, affective phenomena are mostly studied as a consequence of hearing status. This review first addresses anatomical and functional bidirectional connections between auditory and affective systems that support a reciprocal affect-hearing relationship. We then postulate, by focusing on four practical examples (hearing public campaigns, hearing intervention uptake, thorough hearing evaluation, and tinnitus), that some important challenges in audiology are likely affect-related and that potential solutions could be developed by inspiration from affective science advances. We continue by introducing useful resources from affective science that could help audiology professionals learn about the wide range of affective constructs and integrate them into hearing research and clinical practice in structured and applicable ways. Six important considerations for good quality affective audiology research are summarized. We conclude that it is worthwhile and feasible to explore the explanatory power of emotions, feelings, motivations, attitudes, moods, and other affective processes in depth when trying to understand and predict how people with hearing difficulties perceive, react, and adapt to their environment.