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In single-sided deafness patients fitted with a cochlear implant (CI) in the affected ear and preserved normal hearing in the other ear, acoustic and electric hearing can be directly compared without the need for an external control group. Although poor pitch perception is a crucial limitation when listening through CIs, it remains unclear how exactly the cortical processing of pitch information differs between acoustic and electric hearing. Hence, we separately presented both ears of 20 of these patients with vowel sequences in which the pitch contours were either repetitive or variable, while simultaneously recording functional near-infrared spectroscopy (fNIRS) and EEG data. Overall, the results showed smaller and delayed auditory cortex activity in electric hearing, particularly for the P2 event-related potential component, which appears to reflect the processing of voice pitch information. Both the fNIRS data and EEG source reconstructions furthermore showed that vowel sequences with variable pitch contours evoked additional activity in posterior right auditory cortex in electric but not acoustic hearing. This surprising discrepancy demonstrates, firstly, that the acoustic detail transmitted by CIs is sufficient to distinguish between speech sounds that only vary regarding their pitch information. Secondly, the absence of a condition difference when stimulating the normal-hearing ears suggests a saturation of cortical activity levels following unilateral deafness. Taken together, these results provide strong evidence in favour of using CIs in this patient group.

Pitch is an important perceptual feature; however, it is poorly understood how its cortical correlates are shaped by absolute vs relative fundamental frequency (f0), and by neural adaptation. In this study, we assessed transient and sustained auditory evoked fields (AEFs) at the onset, progression, and offset of short pitch height sequences, taking into account the listener's musicality. We show that neuromagnetic activity reflects absolute f0 at pitch onset and offset, and relative f0 at transitions within pitch sequences; further, sequences with fixed f0 lead to larger response suppression than sequences with variable f0 contour, and to enhanced offset activity. Musical listeners exhibit stronger f0-related AEFs and larger differences between their responses to fixed vs variable sequences, both within sequences and at pitch offset. The results resemble prominent psychoacoustic phenomena in the perception of pitch contours; moreover, they suggest a strong influence of adaptive mechanisms on cortical pitch processing which, in turn, might be modulated by a listener's musical expertise.