Technological, biological, and acoustical constraints to music perception in cochlear implant users.

Despite advances in technology, the ability to perceive music remains limited for many cochlear implant users. This paper reviews the technological, biological, and acoustical constraints that make music an especially challenging stimulus for cochlear implant users, while highlighting recent research efforts to overcome these shortcomings. The limitations of cochlear implant devices, which have been optimized for speech comprehension, become evident when applied to music, particularly with regards to inadequate spectral, fine-temporal, and dynamic range representation. Beyond the impoverished information transmitted by the device itself, both peripheral and central auditory nervous system deficits are seen in the presence of sensorineural hearing loss, such as auditory nerve degeneration and abnormal auditory cortex activation. These technological and biological constraints to effective music perception are further compounded by the complexity of the acoustical features of music itself that require the perceptual integration of varying rhythmic, melodic, harmonic, and timbral elements of sound. Cochlear implant users not only have difficulty perceiving spectral components individually (leading to fundamental disruptions in perception of pitch, melody, and harmony) but also display deficits with higher perceptual integration tasks required for music perception, such as auditory stream segregation. Despite these current limitations, focused musical training programs, new assessment methods, and improvements in the representation and transmission of the complex acoustical features of music through technological innovation offer the potential for significant advancements in cochlear implant-mediated music perception.