A bibliometric analysis of research on cognitive function and carotid atherosclerosis: global trends and hotspots

Cognitive impairment associated with carotid atherosclerosis has attracted growing attention in recent years due to its implications in neurodegenerative diseases and vascular dementia. However, the knowledge structure and research trends in this interdisciplinary field remain unclear.

This study conducted a comprehensive bibliometric analysis based on the Web of Science Core Collection and Scopus databases. Publications from 1995 to 2025 related to "cognitive function" and "carotid atherosclerosis" were retrieved, yielding 3,823 unique articles after deduplication using the bibliometrix R package. CiteSpace, VOSviewer, and ggplot2 were applied to visualize publication trends, co-authorship, co-citation networks, keyword clustering, and burst detection.

The number of publications has increased steadily since 2005, with a notable acceleration after 2016. China and the United States are the leading contributors, with Capital Medical University and Harvard Medical School as prominent institutions. Highly cited papers are primarily guideline-based or cohort studies. Keyword clustering revealed three major thematic areas: (1) clinical assessment and epidemiological features of cognitive impairment, (2) neurodegenerative and vascular dementia mechanisms, and (3) cellular injury pathways involving inflammation and oxidative stress. Recent citation bursts of keywords such as "microglia," "postoperative cognitive dysfunction," and "cerebral small vessel disease" indicate a shift toward translational and clinical research. Animal models (e.g., bilateral carotid artery occlusion) and mechanistic studies on neuroinflammation, blood-brain barrier dysfunction, and microglial activation have emerged as key areas of focus.

This bibliometric study outlines the evolution, hotspots, and future directions of research on cognitive function and carotid atherosclerosis. While research output has grown significantly, particularly in China, international collaboration remains uneven. Emerging evidence highlights the critical role of vascular pathology and neuroinflammation in cognitive decline, offering new avenues for diagnosis and intervention. Limitations include potential database bias and a lack of qualitative content assessment. Future work should integrate broader data sources and in-depth analyses to enhance the understanding of this complex domain.