{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:57:33Z","timestamp":1788191853992,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korean Drug Company, Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This multicenter, double-blind, placebo-controlled trial, commissioned by South Korea\u2019s Ministry of Food and Drug Safety, evaluated the effect of oxiracetam for preventing post-stroke cognitive impairment (PSCI) and explored potential interaction with physical activity using neuroimaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Patients at high risk of PSCI, reporting subjective cognitive decline\u2009\u2a7e3\u2009months after stroke, were randomized 1:1 to receive oxiracetam or placebo for 36\u2009weeks. Physical activity was tracked via wrist-worn actigraphy. Coprimary endpoints were changes in Mini-Mental State Examination (MMSE) and Clinical Dementia Rating\u2013Sum of Boxes (CDR-SB). Secondary outcomes included neuropsychological assessments and resting-state functional magnetic resonance imaging network metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 500 enrolled participants (mean age 68.9\u2009years; median 32\u2009months post-stroke), 457 completed the study. There were no statistically significant differences between groups in changes in MMSE (oxiracetam: +0.13\u2009\u00b1\u20092.27 vs placebo: +0.27\u2009\u00b1\u20092.09; p\u2009=\u20090.49) or CDR-SB scores (\u20130.14\u2009\u00b1\u20090.70 vs \u22120.08\u2009\u00b1\u20090.80; p\u2009=\u20090.38). No evidence of interaction was observed between oxiracetam and physical activity. Exploratory analyses suggested favorable trends in functional segregation and CDR-SB scores among highly active oxiracetam participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>Oxiracetam did not demonstrate benefit in preventing PSCI in high-risk patients. These findings support the recent regulatory decision to suspend its use in South Korea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/23969873251350141","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:01:26Z","timestamp":1768906886000},"source":"Crossref","is-referenced-by-count":2,"title":["Oxiracetam and physical activity in preventing cognitive decline after stroke: A multicenter, randomized controlled trial"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6157-2908","authenticated-orcid":false,"given":"Jae-Sung","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joung-Ho","family":"Rha","sequence":"additional","affiliation":[{"name":"Department of Neurology , Inha University Hospital, Inha 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