An Online Self-Guided Meditation Course for Individuals With Multiple Sclerosis

Multiple Sclerosis (MS) is thought to involve a chronic, autoimmune inflammatory process in
which one's own immune system attacks the myelin sheath surrounding axons in the central
nervous system. MS is associated with many symptoms that decrease one's quality of life
including pain, spasticity, fatigue, bowel and bladder problems, dizziness, cognitive
difficulties, and depression. There is currently no cure for MS.

Decreased levels of dopamine (DA) have been measured in the cerebrospinal fluid of those
with the primary progressive type of MS. In individuals with the relapsing- remitting type
of MS, dopamine levels showed a negative correlation to disease severity such that as
dopamine levels decreased, disease severity increased. Additionally, many symptoms of MS are
related to dopaminergic dysfunction and/or abnormalities in dopamine rich brain areas.
Dopamine levels have been shown to increase via active meditation during PET imaging in long
term meditators. Other studies have also linked dopamine release to meditation in the
peripheral nervous system (via measures of a DA metabolite in blood plasma levels). It is
not clear whether brief meditation training in naive participants may have similar effects.
Whether meditation could enhance dopamine levels in patients with MS or meditation naïve
individuals has not been studied. Both dopamine and mindfulness training have been linked to
improved attention and emotion regulation. Research has also indicated that attentional
failures and infrequent use of emotion regulation strategies predicted poorer quality of
life in patients with MS. Thus, there is sufficient evidence to suggest that meditation can
enhance attention, emotion regulation, and quality of life in individuals with MS and that
dopamine may be a neurochemical mechanism for this change.

This study is an open trial pilot design with multiple assessments on measures of
mindfulness, dopamine, inhibition, and emotion regulation. The primary goal of the current
study is evaluate the efficacy of an internet based mindfulness program for individuals with
MS. The investigators hypothesize that individuals with MS will show increased levels of
mindfulness and improved emotion regulation and cognitive inhibition skills after the
course. In addition, The investigators hypothesize that contrast sensitivity (a proxy
measure of retinal dopamine levels) will increase after the course. A secondary goal of this
study is to examine potential cognitive and neurochemical mechanisms of mindfulness in
relation to emotion regulation. Specifically, the investigators propose to examine whether
dopamine and cognitive inhibition mediate the relationship between mindfulness and improved
emotion regulation.

Inclusion Criteria:

- Diagnosis of Multiple Sclerosis

- Must be available for 2 in person visits in Massachusetts

Exclusion Criteria:

- Patients with psychosis.

- Self-reported disorders of the central nervous system other than MS.

- Participants currently engaged in weekly psychotherapy who are unable to reduce
session to once per month for the duration of the study.

- Sensorimotor limitations that would confound test results.

- Daily meditation practice (current or during the last 3 months).

- Medication changes in the past 3 months.

- Participants who, due to their MS are medically unstable. This will be defined as
anyone who is actively relapsing at the time of recruitment (or within the last two
weeks), or who becomes symptomatic during training.