Normal subjects hear complex or vibratoed musical tones as “brighter” than steady pure tones. The reasons that underlie these subjective judgments are difficult to assess. Human patients with stenotic lesions of a vertebral artery, which may impair the blood supply to the brain stem and cochlea, have been found to require unusually long stimuli to achieve a sensation of tone rather than noise from short pure tones. The use of various complex and vibratoed stimuli with these patients supports the data found with pure tones but also shows measureable differences in the speed of tonal processing, and especially suggests improvement in tonal projection. Thus, the data suggest that musical phenomena of “brightness,” “extension,” and the like are linked to the neural efficiency of the hearing process.