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However, regional cerebellar changes associated with motor and non\u2010motor functioning remain to be elucidated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantify cross\u2010sectional regional cerebellar lobule volumes using three dimensional T1\u2010weighted anatomical brain magnetic resonance imaging from the global ENIGMA\u2010PD working group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cerebellar parcellation was performed using a deep learning\u2010based approach from 2487 people with PD and 1212 age and sex\u2010matched controls across 22 sites. Linear mixed effects models compared total and regional cerebellar volume in people with PD at each Hoehn and Yahr (HY) disease stage, to an age\u2010 and sex\u2010 matched control group. Associations with motor symptom severity and Montreal Cognitive Assessment scores were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, people with PD had a regionally smaller posterior lobe (<jats:italic>d<\/jats:italic><jats:sub>max<\/jats:sub>\u2009=\u2009\u22120.15). HY stage\u2010specific analyses revealed a larger anterior lobule V bilaterally (<jats:italic>d<\/jats:italic><jats:sub>max<\/jats:sub>\u2009=\u20090.28) in people with PD in HY stage 1 compared to controls. In contrast, smaller bilateral lobule VII volume in the posterior lobe was observed in HY stages 3, 4, and 5 (<jats:italic>d<\/jats:italic><jats:sub>max<\/jats:sub>\u2009=\u2009\u22120.76), which was incrementally lower with higher disease stage. Within PD, cognitively impaired individuals had lower total cerebellar volume compared to cognitively normal individuals (<jats:italic>d<\/jats:italic>\u2009=\u2009\u22120.17).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We provide evidence of a dissociation between anterior \u201cmotor\u201d lobe and posterior \u201cnon\u2010motor\u201d lobe cerebellar regions in PD. Whereas less severe stages of the disease are associated with larger motor lobe regions, more severe stages of the disease are marked by smaller non\u2010motor regions. \u00a9 2023 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29611","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T10:56:07Z","timestamp":1700045767000},"page":"2269-2281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Cerebellar Volume and Disease Staging in Parkinson's Disease: An <scp>ENIGMA\u2010PD<\/scp> Study"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-9904","authenticated-orcid":false,"given":"Rebecca","family":"Kerestes","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Central 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Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva M.","family":"van Heese","sequence":"additional","affiliation":[{"name":"Department Anatomy and Neurosciences, Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Neuroscience Neurodegeneration  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Al\u2010Bachari","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine The University of Lancaster  Lancaster United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim J.","family":"Anderson","sequence":"additional","affiliation":[{"name":"New Zealand Brain Research Institute  Christchurch New Zealand"},{"name":"Neurology Department Te Whatu Ora \u2010 Health New Zealand Waitaha Canterbury  Christchurch New 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