{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:59:05Z","timestamp":1789595945868,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T00:00:00Z","timestamp":1538697600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000629","name":"Age UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000629","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the relationship between carotid atherosclerosis and cerebral cortical thickness and investigate whether cortical thickness mediates the association between carotid atheroma and relative cognitive decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed 554 community\u2010dwelling subjects (male\/female: 296\/258) from the Lothian Birth Cohort 1936 who underwent brain magnetic resonance imaging and carotid Doppler ultrasound studies at age 73 years. The relationship between carotid atherosclerosis markers (internal carotid artery stenosis, intima\u2013media thickness, velocity, pulsatility, and resistivity indexes) and vertex\u2010wide cerebral cortical thickness was examined cross\u2010sectionally, controlling for gender, extensive vascular risk factors (VRFs), and intelligence quotient at age 11 (IQ\u201011). We also determined the association between carotid stenosis and a composite measure of fluid intelligence at age 73 years. A mediation model was applied to examine whether cortical thickness mediated the relationship between carotid stenosis and cognitive function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A widespread negative association was identified between carotid stenosis (median\u2009=\u200915%) and cerebral cortical thickness at age 73 years, independent of the side of carotid stenosis, other carotid measures, VRFs, and IQ\u201011. This association increased in an almost dose\u2013response relationship from mild to severe degrees of carotid stenosis, across the anterior and posterior circulation territories. A negative association was also noted between carotid stenosis and fluid intelligence (standardized beta coefficient\u2009=\u2009\u22120.151, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), which appeared partly (approximately 22%) mediated by carotid stenosis\u2010related thinning of the cerebral cortex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The findings suggest that carotid stenosis represents a marker of processes that accelerate aging of the cerebral cortex and cognition that is in part independent of measurable VRFs. Cortical thinning within the anterior and posterior circulation territories partially mediated the relationship between carotid atheroma and fluid intelligence.  Ann Neurol 2018;84:576\u2013587<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.25324","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T14:56:25Z","timestamp":1536072985000},"page":"576-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Association between carotid atheroma and cerebral cortex structure at age 73 years"],"prefix":"10.1002","volume":"84","author":[{"given":"Saud","family":"Alhusaini","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherif","family":"Karama","sequence":"additional","affiliation":[{"name":"McConnell Brain Imaging Centre, Montreal Neurological Institute McGill University  Montreal Quebec Canada"},{"name":"Department of Psychiatry, Douglas Mental Health University 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Montreal Neurological Institute McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.","family":"Cox","sequence":"additional","affiliation":[{"name":"Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology University of Edinburgh  Edinburgh United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janie","family":"Corley","sequence":"additional","affiliation":[{"name":"Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology University of Edinburgh  Edinburgh United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Taylor","sequence":"additional","affiliation":[{"name":"Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology University of Edinburgh  Edinburgh United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan 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