Virtual nature walks for depression in progressive multiple sclerosis

Bringing the Outdoors In: Virtual Nature Walks for Depression in Multiple Sclerosis (MS) Patients

This project tests whether immersive at-home virtual-reality nature walks using the Apple Vision Pro, added to usual care, can reduce depressive symptoms in people with progressive MS.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 40 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of Michigan (other)
• Locations: 1 site (Ann Arbor, Michigan)
• Trial ID: NCT07392879 on ClinicalTrials.gov

What this trial studies

This interventional study delivers immersive VR nature experiences on the Apple Vision Pro to people with progressive MS and elevated depressive symptoms, comparing VR plus usual care, VR alone, and usual care alone. Participants complete at-home sessions while researchers measure feasibility, acceptability, and changes in depression, stress, anxiety, sleep, insomnia, and fatigue using PROMIS and other patient-reported measures. The trial emphasizes remote deployment and usability testing of a high-resolution consumer headset to overcome mobility barriers common in progressive MS. Outcomes will compare symptom change and adherence across groups to see if combining VR with current therapies provides greater benefit.

Who should consider this trial

Good fit: Adults with neurologist-confirmed primary or secondary progressive MS who have PROMIS Depression T-scores >55, can consent and use VR at home, and (for some groups) are receiving antidepressant medication or psychotherapy are ideal candidates.

Not a fit: People with severe cognitive or visual impairments, marked motion sickness or claustrophobia, active suicidal ideation or other uncontrolled psychiatric conditions, or those enrolled in other depression trials are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, the intervention could offer an accessible at-home way to reduce depression, stress, and fatigue and improve sleep for people with progressive MS.

How similar studies have performed: Prior VR nature and immersive relaxation studies have shown modest mood and stress improvements in general and some neurological populations, but applying high-resolution headsets like the Apple Vision Pro specifically in progressive MS is largely novel.

Eligibility criteria

Inclusion Criteria:

* Confirmed diagnosis of progressive Multiple Sclerosis (MS, primary or secondary) by a neurologist or an MS center
* Patient-Reported Outcomes Measurement Information System (PROMIS) Depression T-scores \>55 at baseline
* Ability to provide informed consent and participate in VR sessions at home
* For Some Participants (Groups 1 and 2) currently receiving antidepressant or psychotherapy treatments (Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), or psychotherapy) for the management of depression

Exclusion Criteria:

* Severe cognitive impairments or visual deficits that may interfere with VR use, including contraindications like agoraphobia, claustrophobia, or motion sickness
* Current participation in other clinical trials targeting depression
* Severe psychiatric conditions that require hospitalization, or suicidal ideation, passive or active, psychosis, or active substance and alcohol abuse (score greater than 1 on CAGE (Cut down, Annoyed, Guilty, Eye-opener) Adapted to Include Drugs (CAGE-AID))
* Another neurological or autoimmune disease per protocol
* Participants that require vision correction, unless that vision correction is mild (± 1), or the participant has prescription contact lenses.

Where this trial is running

Ann Arbor, Michigan

• University of Michigan — Ann Arbor, Michigan, United States (RECRUITING)

Study contacts

• Principal investigator: Hala Darwish, PhD — University of Michigan
• Study coordinator: Zee Petrie

Conditions: Progressive Multiple Sclerosis, Depression, Immersive virtual reality