Hearing loss and Alzheimer’s Disease (AD) are frequent disorders in the elderly with a significant impact on quality of life (QOL) (Ciorba et al., 2012; Livingston et al., 2020). Epidemiological studies have demonstrated an association between these conditions and the role of hearing loss as a potentially modifiable risk factor for AD (Lin et al., 2011; Livingston et al., 2020; Swords et al., 2018).

Recent findings reported that both peripheral and central auditory system dysfunction can occur in the prodromal stages of AD and therefore may represent early indicators of the disease (Swords et al., 2018). Hearing loss not only precedes but also accelerates cognitive decline, and this effect appears to be independent of the cognitive demands involved in auditory and speech perception tasks. (Hardy et al., 2016; Lin et al., 2011; Taljaard et al., 2016).

Moreover, it has been suggested that screening for auditory dysfunction in at-risk populations is a cost-effective approach to detect early AD pathology and may provide an entry point for therapeutic interventions aimed at improving QOL in patients with AD while potentially slowing disease progression (Swords et al., 2018).

A topographically specific and consistent pattern of degeneration in the auditory system was observed in autopsy-based studies of late-stages AD patients (Baloyannis et al., 2011; Braak and Braak, 1991; Sinha et al., 1993). Furthermore, auditory cortex (AC) impairment was also revealed in histopathologic studies in older adults with age-related hearing loss (Lin et al., 2014; Peelle et al., 2011; Qian et al., 2017).

Despite this evidence, few studies have specifically addressed structural changes in the AC—including primary, secondary, and association areas—using magnetic resonance imaging (MRI) in AD patients (Belathur Suresh et al., 2018). By contrast, gray matter atrophy in the AC has been widely described in the ageing brain with hearing loss, particularly affecting the high-frequency components typical of presbycusis (Eckert et al., 2012; Peelle et al., 2011; Qian et al., 2017).

A better understanding of the structural involvement of the AC in AD, and how it is affected across disease stages, may provide insights into mechanisms of disease progression and aid in early diagnosis. Therefore, the present study aims to investigate whether the AC is affected in patients with AD and mild cognitive impairment (MCI) using brain MRI.