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Hearing loss is a key early marker of such decline and is linked to numerous comorbidities in older adults. Yet, ~10% of middle-aged individuals who report hearing difficulties show normal audiograms. Cochlear neural degeneration (CND) could contribute to these hidden hearing deficits, though its role remains unclear due to a lack of objective diagnostics and uncertainty regarding its perceptual outcomes. Here, we employed a cross-species design to examine neural and behavioral signatures of CND. We measured envelope following responses (EFRs) \u2013 neural ensemble responses to sound originating from the peripheral auditory pathway \u2013 in young and middle-aged adults with normal audiograms and compared these responses to young and middle-aged Mongolian gerbils, where CND was histologically confirmed. We observed near-identical changes in EFRs across species that were associated with CND. Behavioral assessments revealed age-related speech-in-noise deficits under challenging conditions, while pupil-indexed listening effort increased with age even when behavioral performance was matched. Together, these results demonstrate that CND contributes to speech perception difficulties and elevated listening effort in midlife, which may ultimately lead to listening fatigue and social withdrawal.<\/jats:p>","DOI":"10.7554\/elife.102823","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T11:25:14Z","timestamp":1731583514000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.102823","source":"Crossref","is-referenced-by-count":15,"title":["Increased listening effort and cochlear neural degeneration underlie speech-in-noise deficits in normal-hearing middle-aged adults"],"prefix":"10.7554","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2018-2772","authenticated-orcid":true,"given":"Maggie E","family":"Zink","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01an3r305","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Communication Science and Disorders, School of Health and Rehabilitation 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