• Individuals with speech-in-noise difficulties exhibit stronger insula connectivity, even when the brain is not actively processing sound.
• Insula rewiring may explain connections between hearing loss and cognitive decline, including early dementia.
• Exposure to noisy environments may help train the brain to better process speech, offering potential for improved hearing.

A new study by University at Buffalo researchers has identified the insula, a brain region, as showing significant changes in individuals who struggle to understand speech in noisy environments. Using resting-state MRI, the study found that the left insula exhibits stronger connectivity with auditory regions, even at rest, suggesting a permanent rewiring of brain networks. This discovery contributes to the growing understanding of the link between hearing loss and cognitive impairment, potentially leading to dementia. The findings offer insights into how dementia may develop and suggest potential therapeutic interventions.

• What: Research identifies altered connectivity in the insula, a brain region, in individuals struggling to understand speech in noisy environments.
• Who: David S. Wack, PhD, and researchers at the University at Buffalo, along with co-authors from various institutions.
• When: The study was published in May 7, 2025. The MRI tests were conducted on participants aged 20-80.
• Where: The research was conducted at the University at Buffalo, with imaging work done at the Center for Biomedical Imaging in UB’s Clinical and Translational Science Institute.

This study sheds light on the neurological basis of speech-in-noise difficulties and its potential link to cognitive decline. The finding that the insula works harder even at rest in individuals with hearing challenges suggests a permanent rewiring of brain networks. This could have significant implications for understanding and potentially mitigating the cognitive effects of hearing loss. The unexpected finding about a participant who improved speech-in-noise understanding through exposure to noisy environments offers hope for therapeutic interventions.

Your brain is always doing something. And when you have hearing loss, you are recruiting other areas of the brain to do more processing in order to decode what’s going on.

It’s not that hearing loss causes dementia, but if we could find a way to preserve the fidelity of the signal coming in, then the brain wouldn’t have to start compensating for that hearing loss.

By identifying shared neural networks at rest, our research adds to the understanding of why addressing hearing difficulties might help with cognitive function.

The University at Buffalo study provides valuable insights into the neurological mechanisms underlying speech-in-noise difficulties and their connection to cognitive decline. The identification of insula rewiring as a key factor opens new avenues for research and potential therapeutic interventions. The finding that exposure to noisy environments can improve speech-in-noise understanding offers a promising direction for future studies aimed at improving hearing and cognitive function.