Cerebellar volumes’ selective association with MoCA over MMSE: a diagnostic insight into mild cognitive impairment and mild dementia

Introduction Linked to motor control, cerebellum is increasingly recognized for its role in cognition and neurodegenerative disorders. Methods This retrospective study investigates associations between cerebellar volumes and cognitive screening tools—the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA)—in individuals with mild cognitive impairment (MCI) or mild dementia. Results MoCA scores showed significant positive correlations with cognitive-related cerebellar regions, particularly the left Crus I lobule (r = 0.40, p = 0.02) and total Crus I volume (r = 0.36, p = 0.04). Regression analysis confirmed associations with the left Crus I (β = 0.08, p = 0.02) and right VIIB lobule (β = 0.033, p = 0.032), while MMSE scores correlated only with right Lobule X thickness (r = -0.35, p = 0.04). Discussion These findings suggest MoCA may better detect cerebellar-related cognitive impairments, underscoring the importance of including cerebellar evaluation in the early diagnosis of dementia.