biostudies-literatureArmstrong AGWellcome Trust717-730https://www.ebi.ac.uk/biostudies/studies/S-EPMC7612903biostudies-literatureUnknown6(6)In quiet environments, hearing aids improve the perception of low-intensity sounds. However, for high-intensity sounds in background noise, the aids often fail to provide a benefit to the wearer. Here, using large-scale single-neuron recordings from hearing-impaired gerbils-an established animal model of human hearing-we show that hearing aids restore the sensitivity of neural responses to speech, but not their selectivity. Rather than reflecting a deficit in supra-threshold auditory processing, the low selectivity is a consequence of hearing-aid compression (which decreases the spectral and temporal contrasts of incoming sound) and amplification (which distorts neural responses, regardless of whether hearing is impaired). Processing strategies that avoid the trade-off between neural sensitivity and selectivity should improve the performance of hearing aids.Nature biomedical engineeringCompression and amplification algorithms in hearing aids impair the selectivity of neural responses to speech.PMC7612903200942/Z/16/Z200942Lam CCSabesan SLesica NAArmstrong AGfalseCompression and amplification algorithms in hearing aids impair the selectivity of neural responses to speech.In quiet environments, hearing aids improve the perception of low-intensity sounds. However, for high-intensity sounds in background noise, the aids often fail to provide a benefit to the wearer. Here, using large-scale single-neuron recordings from hearing-impaired gerbils-an established animal model of human hearing-we show that hearing aids restore the sensitivity of neural responses to speech, but not their selectivity. Rather than reflecting a deficit in supra-threshold auditory processing, the low selectivity is a consequence of hearing-aid compression (which decreases the spectral and temporal contrasts of incoming sound) and amplification (which distorts neural responses, regardless of whether hearing is impaired). Processing strategies that avoid the trade-off between neural sensitivity and selectivity should improve the performance of hearing aids.2022-01-01T00:00:00Z2022 Jun2026-06-02T21:51:36.666Z2025-02-18T23:36:17.167ZS-EPMC76129033394189810.1038/s41551-021-00707-y