Design and Rationale for a Cognitive Outcome Substudy in Ischemic Stroke Patients with High Risk of Cerebral Hemorrhage

Kyung Ho Yu, Keun Sik Hong, Mi Sun Oh, Juneyoung Lee, Ji Sung Lee, Sun U. Kwon

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Goal Cognitive impairment and dementia are common disabilities after stroke and are associated with increased risks of mortality and recurrent stroke. The prevention of dementia and preserving cognitive function are also important in stroke patients, but its strategy is not established yet. This PICASSO-COG (PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage for reducing COGnitive decline) substudy aims to assess the effects of cilostazol and/or probucol on cognitive function. Materials and methods The substudy aims to assess the reduction in cognitive decline of patients treated with cilostazol and/or probucol in the PICASSO trial. Patients will be assessed using the Korean version of mini-mental state examination and Montreal Cognitive Assessment at 4, 7, 10, 13, 25, 37, and 49 months after randomization. The primary outcome is the change in mini-mental status examination score, compared between treatment groups, with a modified intention-to-treat population using a restricted maximum likelihood-based mixed effects model repeat measurement. This will allow a within-subject correlation due to repeated cognitive tests as well as a different number of measurements among subjects at baseline and each follow-up period. Conclusion PICASSO-COG is a novel study for assessing the effect on cognitive function of different antiplatelet regimens and the addition of a nonstatin lipid-lowering agent to the current standard statin therapy in patients who have a recent ischemic lesion and prior intracerebral macro- or microbleeds.

Original languageEnglish
Pages (from-to)2061-2066
Number of pages6
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number8
Publication statusPublished - 2016 Aug 1
Externally publishedYes


  • Cognitive impairment
  • cerebral infarction
  • cilostazol
  • clinical trial
  • intracerebral hemorrhage
  • microbleeds
  • probucol
  • vascular dementia

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


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