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RecruitingNCT05223426SYNAPSEUpdated Nov 14, 2023

Effects of Individualized Cognitive Training on Cognition in Heart Failure

An interventional study of Cognitive training and Usual Care in Heart Failure, sponsored by Louis Bherer. Recruiting at 2 sites in Canada. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2023-11-14.

Sponsored by Louis Bherer · Not applicable, Interventional, and Prevention

From the registry’s dates

  • Primary completion was expected by Nov 2024, 1 year 11 months ago, but the record still lists the study as recruiting.
  • Started Jan 2023; still recruiting 3 years 8 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
54
Allocation
Randomized
Ages
50 Years and older
Sex
All
01

Study summary

The SYNAPSE trial is designed to study the effects of an individualized home-based cognitive training program on cognitive functions in heart-failure patients.

Read the detailed description

The purpose of the SYNAPSE study is to evaluate the effects of an individualized home-based training program aimed to improve cognitive functions and well-being in heart failure patients. Heart failure is characterized by the inability of the heart to pump blood efficiently through the body. Nearly half of patients with heart failure present with cognitive deficits. Memory and executive functions that allow us to perform complex tasks are mainly affected. These cognitive deficits are linked to an increased risk of hospitalization and mortality, in addition to decreasing patients' well-being and ability to care for themselves. Although rehabilitation programs that include physical activity and counseling help reduce heart and brain health risks, these programs are unpopular. Among the few who enroll, between 24% and 50% drop out before the completion of the program. Offering alternative options such as cognitive training would help to reach this proportion of patients. The literature has shown that cognitive training is effective in preventing or reducing cognitive deficits in older adults with or without cognitive loss. Although still understudied in patients with heart failure, a better understanding of the association between heart failure and changes in cognition would allow better adaptation of patient care to their situations and needs.

02

Conditions studied

  • Heart Failure

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Keywords

  • Heart failure
  • Cognition
  • Individualized cognitive training
  • Home-based intervention
  • Remote monitoring
03

In context

Heart Failure

5,701 studies on the registry are indexed under Heart Failure; 1,220 are open to participants now.

This study's planned enrollment of 54 is below the median of 72 across 3,736 interventional studies indexed under Heart Failure.

Browse Heart Failure studies →

Lead sponsor

Louis Bherer is the lead sponsor of 6 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adult aged 50 or older
  • Have access to Internet
  • Have access to a computer or a tablet;
  • Have the ability to perform cognitive training;
  • Have the ability to read, understand and consent to the informed consent form;
  • Have chronic heart failure on tolerated therapy for at least two months;
  • Without limitation of physical activity to severe limitation of physical activity (i.e. NYHA class I, class II, class III OR class IV).

Exclusion criteria

Exclusion Criteria:

  • Acute cardiovascular event 1 month before randomization;
  • Cardiovascular procedure scheduled within 3 months;
  • Uncontrolled diabetes or untreated thyroid dysfunction;
  • Current or recent malignancy with a life expectancy of less than 1 year;
  • Neurological disease;
  • Chronic hemodialysis or peritoneal dialysis.
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Outcomes assessor)
Enrollment
54 participants (estimated)

Study arms

  • Experimental
    Cognitive training followed by usual care

    Usual care and cognitive training for 6 weeks, followed by usual care (only) for 6 weeks.

    Other: Cognitive training · Other: Usual Care

  • Experimental
    Usual care followed by cognitive training

    Usual care (only) for 6 weeks, followed by cognitive training and usual care for 6 weeks.

    Other: Cognitive training · Other: Usual Care

Interventions

  • OtherCognitive training

    A cognitive training program will be individually developed for each participant based on baseline neuropsychological tests. It will include: Computerized cognitive training: this training include: the Dual-Task, the Stroop and the N-Back task. The tasks are accompanied by feedback based on the participant's responses (e.g., progress graph, feedback, etc.). In order to promote participants' learning, the level of difficulty of the tasks increased as training sessions progressed. Two sets of stimuli will be used to maximize the generalization of learning. Memory training: This training is adapted from the MEMO+ training program (Belleville et al., 2018). These sessions, also home-based, will be done through online video and are covering a variety of topics: memory (normal aging, mnemonic strategies), attention, aging, etc. Each week, participants will be asked to complete the equivalent of 6 training sessions of 15 minutes each, for a total of 1h30 per week.

  • OtherUsual Care

    Participants will be asked to continue the care and follow-up as usually planned with the attending cardiologist. Apart from weekly follow-ups with the research team member, no changes will be made to the participant's medical care.

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What researchers measure

Primary outcomes

  1. Changes in performance on trained computerized cognitive tasks

    Trained version of computerized dual-task, modified stroop and n-back tasks Reaction time (ms)

    Time frame: Before and after the 6 weeks of interventions

  2. Changes in performance on trained computerized cognitive tasks

    Trained version of computerized dual-task, modified stroop and n-back tasks Accuracy (%)

    Time frame: Before and after the 6 weeks of interventions

  3. Changes in performance on transfer computerized cognitive tasks

    Transfer version of computerized dual-task, modified stroop and n-back tasks Reaction time (ms)

    Time frame: Before and after the 6 weeks of interventions

  4. Changes in performance on transfer computerized cognitive tasks

    Transfer version of computerized dual-task, modified stroop and n-back tasks Accuracy (%)

    Time frame: Before and after the 6 weeks of interventions

Secondary outcomes

  1. Change in general cognitive functioning

    Remote version of the Montreal Cognitive Assessment. (0-28 score, with a higher score indicating a better cognitive functioning.)

    Time frame: Before and after the 6 weeks of interventions

  2. Changes in performance on neuropsychological tests

    Remote version of validated neuropsychological test Memory capacity -Rey Auditory Verbal Learning Test (z-score change)

    Time frame: Before and after the 6 weeks of interventions

  3. Changes in performance on neuropsychological tests

    Remote version of validated neuropsychological test Processing speed -Trail making test Part A (z-score change)

    Time frame: Before and after the 6 weeks of interventions

  4. Changes in performance on neuropsychological tests

    Remote version of validated neuropsychological test Executive functions * Trail making test Part B * Verbal fluency test * Digit span test (z-score change)

    Time frame: Before and after the 6 weeks of interventions

  5. Change in quality of life

    36-Items Short form health Survey (SF-36) (Score ranges from 0-100, with a higher score indicating more favorable health status.)

    Time frame: Before and after the 6 weeks of interventions

  6. Change in self-care behavior

    European Heart-Failure Self-care Behavior Scale-9 (EHFsB-9) (The minimal score is 9 while the maximal score is 45. The higher the score, the less the patient performs self-care behaviors.)

    Time frame: Before and after the 6 weeks of interventions

Other outcomes

  1. Change in depressive symptomatology

    Patient Health Questionnaire (PHQ-9) (Score ranges from 0 to 27, with a higher score indicating a more severe depression state.)

    Time frame: Before and after the 6 weeks of interventions

  2. Change in anxiety

    General Anxiety Disorder questionnaire (GAD-7) (Total score ranges from 0 to 21, with an increasing score on the scale is indicating a worse anxiety state.)

    Time frame: Before and after the 6 weeks of interventions

  3. Change in perceived stress

    Perceived Stress Scale questionnaire (PSS-10) (Score ranges from 0-40, with a higher score indicating a worse sleep quality)

    Time frame: Before and after the 6 weeks of interventions

  4. Change in quality of sleep

    Pittsburgh Sleep Quality Index questionnaire (PSQI) (19 self-assessment questions are grouped into seven components. The scores for the seven components are summed to give an overall score that ranges from 0 to 21 points, with "0" indicating no difficulty and "21" indicating severe difficulty in all components. A score higher than 5 indicates problematic sleep in one or more components)

    Time frame: Before and after the 6 weeks of interventions

  5. Change in Risk of sleep apnea

    Berlin Questionnaire (Participants are classified into a high or a low risk of sleep apnea based their responses to the individual items and their overall scores in the symptom categories. A High Risk represent 2 or more categories where the score is positive. A low risk represents 1 or no category where the score is positive.)

    Time frame: Before and after the 6 weeks of interventions

  6. Change in self-reported physical activity

    Physical Activity Scale for the Elderly Questionnaire (PASE) (The overall score ranges from 0 to 400, with a higher score indicating a better level of physical activity)

    Time frame: Before and after the 6 weeks of interventions

  7. Change in Walking test speed

    4-meter walking test (m/s)

    Time frame: Before and after the 6 weeks of interventions

  8. Change in functional mobility

    Timed up and Go test (s)

    Time frame: Before and after the 6 weeks of interventions

  9. Change in balance performance

    Timed one-leg standing test (s)

    Time frame: Before and after the 6 weeks of interventions

  10. Change in lower limb muscles strength

    Timed Sit-to-Stand test (s)

    Time frame: Before and after the 6 weeks of interventions

  11. Cognitive Reserve

    Rami and colleagues' cognitive reserve questionnaire (Scale ranges from 0-26, with a higher score indicating a greater cognitive reserve)

    Time frame: Baseline

  12. Self-reported masculinity and femininity traits

    Short Form BEM Sex-Role Inventory questionnaire (30 items questionnaire with 10 items assessing the femininity traits, 10 items assessing the masculinity traits and 10 items neutral, not scored. Two scores, rage from 10-70, are calculated for femininity and masculinity, respectively. A higher score is indicating a higher trait.)

    Time frame: Baseline

  13. Dietary patterns

    Short Diet Questionnaire (Score ranges from 15-45 points, with a score between 15-29 categorized as unhealthy, 30-37 as somewhat unhealthy and 38 or more as a healthy diet.)

    Time frame: Baseline

07

Study locations

1 of 2 sites recruiting
  • Preventive medicine and physical activity center (centre EPIC), Montreal heart Institute
    Montréal, Quebec H1T1N6, Canada
    Not yet recruiting
  • Centre de recherche du centre Hospitalier de l'Université de Montréal (CRCHUM)
    Montréal, Quebec, Canada
    Recruiting
08

References and documents

Publications

  • Turk-Adawi KI, Oldridge NB, Tarima SS, Stason WB, Shepard DS. Cardiac rehabilitation patient and organizational factors: what keeps patients in programs? J Am Heart Assoc. 2013 Oct 21;2(5):e000418. doi: 10.1161/JAHA.113.000418. PubMed 24145743 ↗
  • Resurreccion DM, Moreno-Peral P, Gomez-Herranz M, Rubio-Valera M, Pastor L, Caldas de Almeida JM, Motrico E. Factors associated with non-participation in and dropout from cardiac rehabilitation programmes: a systematic review of prospective cohort studies. Eur J Cardiovasc Nurs. 2019 Jan;18(1):38-47. doi: 10.1177/1474515118783157. Epub 2018 Jun 18. PubMed 29909641 ↗
  • Rego MLM, Cabral DAR, Fontes EB. Cognitive Deficit in Heart Failure and the Benefits of Aerobic Physical Activity. Arq Bras Cardiol. 2018 Jan;110(1):91-94. doi: 10.5935/abc.20180002. PubMed 29538528 ↗
  • Leto L, Feola M. Cognitive impairment in heart failure patients. J Geriatr Cardiol. 2014 Dec;11(4):316-28. doi: 10.11909/j.issn.1671-5411.2014.04.007. PubMed 25593581 ↗
  • Hawkins MA, Schaefer JT, Gunstad J, Dolansky MA, Redle JD, Josephson R, Moore SM, Hughes JW. What is your patient's cognitive profile? Three distinct subgroups of cognitive function in persons with heart failure. Appl Nurs Res. 2015 May;28(2):186-91. doi: 10.1016/j.apnr.2014.10.005. Epub 2014 Oct 31. PubMed 25510559 ↗
  • Doehner W. Dementia and the heart failure patient. Eur Heart J Suppl. 2019 Dec;21(Suppl L):L28-L31. doi: 10.1093/eurheartj/suz242. Epub 2019 Dec 23. PubMed 31885510 ↗
  • Dodson JA, Chaudhry SI. Geriatric conditions in heart failure. Curr Cardiovasc Risk Rep. 2012 Oct;6(5):404-410. doi: 10.1007/s12170-012-0259-8. PubMed 23997843 ↗
  • Dickson VV, Tkacs N, Riegel B. Cognitive influences on self-care decision making in persons with heart failure. Am Heart J. 2007 Sep;154(3):424-31. doi: 10.1016/j.ahj.2007.04.058. PubMed 17719284 ↗
  • de Tournay-Jette E, Dupuis G, Denault A, Cartier R, Bherer L. The benefits of cognitive training after a coronary artery bypass graft surgery. J Behav Med. 2012 Oct;35(5):557-68. doi: 10.1007/s10865-011-9384-y. Epub 2011 Nov 9. PubMed 22068879 ↗
  • Cannon JA, Moffitt P, Perez-Moreno AC, Walters MR, Broomfield NM, McMurray JJV, Quinn TJ. Cognitive Impairment and Heart Failure: Systematic Review and Meta-Analysis. J Card Fail. 2017 Jun;23(6):464-475. doi: 10.1016/j.cardfail.2017.04.007. Epub 2017 Apr 19. PubMed 28433667 ↗
  • Belleville S, Hudon C, Bier N, Brodeur C, Gilbert B, Grenier S, Ouellet MC, Viscogliosi C, Gauthier S. MEMO+: Efficacy, Durability and Effect of Cognitive Training and Psychosocial Intervention in Individuals with Mild Cognitive Impairment. J Am Geriatr Soc. 2018 Apr;66(4):655-663. doi: 10.1111/jgs.15192. Epub 2018 Jan 4. PubMed 29313875 ↗
  • Kua ZJ, Valenzuela M, Dong Y. Can Computerized Cognitive Training Improve Cognition in Patients With Heart Failure?: A Review. J Cardiovasc Nurs. 2019 Mar/Apr;34(2):E19-E27. doi: 10.1097/JCN.0000000000000558. PubMed 30585868 ↗
  • Bherer L. Cognitive plasticity in older adults: effects of cognitive training and physical exercise. Ann N Y Acad Sci. 2015 Mar;1337:1-6. doi: 10.1111/nyas.12682. PubMed 25773610 ↗
  • Lampit A, Hallock H, Valenzuela M. Computerized cognitive training in cognitively healthy older adults: a systematic review and meta-analysis of effect modifiers. PLoS Med. 2014 Nov 18;11(11):e1001756. doi: 10.1371/journal.pmed.1001756. eCollection 2014 Nov. PubMed 25405755 ↗
  • Lussier M, Gagnon C, Bherer L. An investigation of response and stimulus modality transfer effects after dual-task training in younger and older. Front Hum Neurosci. 2012 May 18;6:129. doi: 10.3389/fnhum.2012.00129. eCollection 2012. PubMed 22629239 ↗
  • Pendlebury ST, Welch SJ, Cuthbertson FC, Mariz J, Mehta Z, Rothwell PM. Telephone assessment of cognition after transient ischemic attack and stroke: modified telephone interview of cognitive status and telephone Montreal Cognitive Assessment versus face-to-face Montreal Cognitive Assessment and neuropsychological battery. Stroke. 2013 Jan;44(1):227-9. doi: 10.1161/STROKEAHA.112.673384. Epub 2012 Nov 8. PubMed 23138443 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 14, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05223426
Lead sponsor
Louis Bherer
Collaborators
The Montreal Health Innovations Coordinating Center (MHICC)
Responsible party
Louis Bherer (Associate scientific director, Direction of prevention, Montreal heart Institute, Montreal Heart Institute) — Sponsor-investigator
First posted
Feb 4, 2022
Start date
Jan 19, 2023
Primary completion
Nov 2024 (estimated)
Completion
Nov 2024 (estimated)
Last update
Nov 14, 2023

Study contacts

Louis Bherer, PhD
Contact
louis.bherer@umontreal.ca
514-376-3330 ext. 2059
Caroll-Ann Blanchette, MSc
Contact
caroll-ann.blanchette-bisson@umontreal.ca
514-374-1480 ext. 4340
Louis Bherer, PhD
principal investigator · Montreal Heart Institute

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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