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.