[P4–574]: REDUCING COGNITIVE DECLINE WITH PROBUCOL IN ISCHEMIC STROKE PATIENTS WITH HIGH RISK OF CEREBRAL HEMORRHAGE: PICASSO‐COG TRIAL
Bibliographic record
Abstract
Multiple cerebral microbleeds (CMBs) and prior intracerebral hemorrhage (ICH) are associated with higher risk of cognitive decline after stroke. We aimed to investigate the efficacy of probucol, a lipid-lowering and anti-oxidative agent, to prevent cognitive decline in stroke patients with multiple CMBs or prior ICH. PICASSO-Cog study is a predefined substudy of a randomized controlled clinical trial, PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage (PICASSO). Patients with non-cardioembolic ischemic stroke or transient ischemic attack within 180 days and with previous ICH or multiple CMBs on gradient echo imaging were randomized to probucol versus no probucol groups from 61 institutes of South Korea. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) was conducted at 4 (baseline), 13, 25, 37, and 49 months after index-stroke. Changes in MMSE and MoCA scores over time from baseline were analyzed using mixed effects model. A total 892 subjects were included in the analysis, with a median follow-up of 20.9 months. Mean age was 64.9 ± 10.8 years, median National Institute of Health Stroke Scale score 1 (IQR 0 - 3), and baseline MMSE score 25.0 ± 4.6. Mean changes of MMSE from baseline to each follow-up was 0.02±2.45 (1, n=888), -0.15±2.65 (2, n=593), -0.24±3.11 (3, n=361), and -0.88±3.06 (4, n=138). The MMSE scores over time showed a favorable trend for probucol treatment, but not significant. Among them, a total of 877 subjects underwent MoCA at least twice after randomization. Baseline MoCA score 19.3 ± 6.2, and mean changes of MoCA from baseline to each follow-up was 0.02 ± 2.83 (1st, n=871), -0.20 ± 3.17 (2nd, n=582), -0.09 ± 3.59 (3rd, n=354), and -0.52 ± 3.49 (4th, n=132). Probucol could significantly prevent cognitive decline in MoCA scores compared to placebo (p=0.01 for treatment effect). These effects were observed in the subgroups without diabetes mellitus, with concomitant lipid-lowering agent, baseline MMSE score > 24, and mild to moderate white matter hyperintensities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".