Background and objectives: Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). It can be defined as a subjective lack of physical and mental energy. The aim of this study was to evaluate the frequency and severity of fatigue in patients with MS and its relationship with overall physical activity and disease-related disability. Materials and Methods: The study included 100 patients with a clinical relapsing-remitting form of MS. Patients with severe depression were excluded. Neurological impairment was rated using the Expanded Disability Status Scale (EDSS). Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS), with FSS scores greater than 36 indicating patients with fatigue. Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ) and categorized on three levels: low, moderate, and high, using standard metabolic equivalents (MET). Results: The average FSS and MFIS scores were (mean ± SD) 31.3 ± 15.2 and 30.1 ± 17.0, respectively. The mean EDSS score was 2.5 ± 1.5. 42%. Patients were classified as fatigued based on FSS. Fatigued patients had higher mean EDSS scores than non-fatigued (3.0 ± 1.6 vs. 2.2 ± 1.4, respectively, p = 0.002). Low, moderate, and high levels of physical activity were reported in 35%, 20%, and 45% of patients, respectively. Higher scores of fatigue in FSS and MFIS were inversely correlated with the intensity of physical activity (r = −0.38, p < 0.001 and r = −0.33, p < 0.001, respectively). Conclusions: In patients with MS, fatigue is a common symptom. Patients with lower physical activity and greater MS-related disability have a higher severity of fatigue, which negatively affects cognitive, psychosocial, and physical functioning.

Background and Objectives: A growing number of studies correlated higher levels of serum uric acid (UA) with both: lower risk of Parkinson’s Disease (PD) occurrence and slower progression of the disease. Similar conclusions were made where studies correlated UA with atypical Parkinsonisms (AP) progression. A few researchers have studied the issue of the influence of serum UA on the occurrence of non-motor symptoms (NMS) in PD and AP. Our systematic review is the first review completely dedicated to this matter. Materials and Methods: A comprehensive evaluation of the literature was performed to review the relationship between UA and NMS in PD and AP. The systematic review was conducted according to PRISMA Statement guidelines. The following databases were searched starting in April 2021: MEDLINE via PubMed, Embase, and Scopus. During the research, the following filters were used: >2010, articles in English, concerning humans. The study was not registered and received no external funding. Results: Seven articles meeting all inclusion criteria were included in this study. Collectively, data on 1104 patients were analyzed. A correlation between serum UA concentration and a few NMS types has been provided by the analyzed studies. In four papers, sleep disorders and fatigue were related to UA for both advanced and early PD. Other commonly appearing NMS domains were Attention/memory (4 studies), Depression/anxiety (3 studies), Cardiovascular (3 studies), Gastrointestinal (1 study), Perceptual (1 study), and Miscellaneous (1 study). For AP, no significant correlation between UA and worsening of NMS has been found. Conclusions: Based on the analyzed studies, a correlation between serum UA level and the occurrence and worsening of NMS in PD and APs cannot be definitively determined. Large-scale studies with a more diverse patient population and with more accurate methods of NMS assessment in Parkinsonism are needed.

Background and Objectives: Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the world. It is characterized by the presence of not only typical motor symptoms but also several less known and aware non-motor symptoms (NMS). The group of disorders included in the NMS is Impulse Control Disorders (ICDs). ICDs are a group of disorders in which patients are unable to resist temptations and feel a strong, pressing desire for specific activities such as gambling, hypersexuality, binge eating, and compulsive buying. The occurrence of ICDs is believed to be associated primarily with dopaminergic treatment, with the use of dopamine agonists (DA), and to a lesser extent with high doses of L-dopa. The aim of our study was to develop a profile of Polish ICDs patients and assess the frequency of occurrence of ICDs, as well as determine the risk factors associated with these disorders against the background of the PD population from other countries. Materials and Methods: Our prospective study included 135 patients with idiopathic PD who were hospitalized between 2020 and 2022 at the Neurological Department of University Central Hospital in Katowice. In the assessment of ICDs, we used the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP). Other scales with which we assessed patients with PD were as follows: MDS-UPDRS part III and modified Hoehn–Yahr staging. Clinical data on age, gender, disease duration and onset, motor complications, and medications were collected from electronic records. Results: ICDs were detected in 27.41% of PD patients (binge eating in 12.59%, hypersexuality in 11.11%, compulsive buying in 10.37%, and pathological gambling occurred in only 5.19% of patients. In total, 8.89% had two or more ICDs). The major finding was that ICDs were more common in patients taking DA than in those who did not use medication from this group (83.78% vs. 54.07%, respectively; p = 0.0015). Patients with ICDs had longer disease duration, the presence of motor complications, and sleep disorders. An important finding was also a very low detection of ICDs in a routine medical examination; only 13.51% of all patients with ICDs had a positive medical history of this disorder. Conclusions: ICDs are relatively common in the population of Polish PD patients. The risk factors for developing ICDs include longer duration of the disease, presence of motor complications, sleep disorders, and use of DA and L-dopa. Due to the low detectability of ICDs in routine medical history, it is essential for physicians to pay more attention to the possibility of the occurrence of these symptoms, especially in patients with several risk factors. Further prospective studies on a larger group of PD patients are needed to establish a full profile of Polish PD patients with ICDs.

Background and Objectives: Impulse control disorders (ICDs) are characterized by potentially harmful actions resulting from disturbances in the self-control of emotions and behavior. ICDs include disorders such as gambling, hypersexuality, binge eating, and compulsive buying. ICDs are known non-motor symptoms in Parkinson’s disease (PD) and are associated primarily with the use of dopaminergic treatment (DRT) and especially dopamine agonists (DA). However, in atypical parkinsonism (APS), such as progressive supranuclear palsy (PSP) or multiple system atrophy (MSA), there are only single case reports of ICDs without attempts to determine the risk factors for their occurrence. Moreover, numerous reports in the literature indicate increased impulsivity in PSP. Our study aimed to determine the frequency of individual ICDs in APS compared to PD and identify potential factors for developing ICDs in APS. Materials and Methods: Our prospective study included 185 patients with PD and 35 with APS (27 patients with PSP and 9 with MSA) hospitalized between 2020 and 2023 at the Neurological Department of University Central Hospital in Katowice. Each patient was examined using the Questionnaire for Impulsive–Compulsive Disorders in Parkinson’s Disease (QUIP) to assess ICDs. Additionally, other scales were used to assess the advancement of the disease, the severity of depression, and cognitive impairment. Information on age, gender, age of onset, disease duration, and treatment used were collected from medical records and patient interviews. Results: ICDs were detected in 23.39% of patients with PD (including binge eating in 11.54%, compulsive buying in 10.44%, hypersexuality in 8.79%, and pathological gambling in 4.40%), in one patient with MSA (hypersexuality and pathological gambling), and in 18.52% of patients with PSP (binge eating in 3.70%, compulsive buying in 7.41%, and hypersexuality in 11.11%). We found no differences in the frequency of ICDs between individual diseases (p = 0.4696). We confirmed that the use of higher doses of DA and L-dopa in patients with PD, as well as a longer disease duration and the presence of motor complications, were associated with a higher incidence of ICDs. However, we did not find any treatment effect on the incidence of ICDs in APS. Conclusions: ICDs are common and occur with a similar frequency in PD and APS. Well-described risk factors for ICDs in PD, such as the use of DRT or longer disease duration, are not fully reflected in the risk factors for ICDs in APS. This applies especially to PSP, which, unlike PD and MSA, is a tauopathy in which, in addition to the use of DRT, other mechanisms related to the disease, such as disorders in neuronal loops and neurotransmitter deficits, may influence the development of ICDs. Further prospective multicenter studies recruiting larger groups of patients are needed to fully determine the risk factors and mechanisms of ICD development in APS.

Background and Objectives: Impulse control disorders (ICDs) are frequent non-motor complications of Parkinson’s disease (PD), usually related to dopaminergic therapy. Uric acid (UA) has been studied as a biomarker of PD severity and has been linked to impulsivity in non-PD populations. However, its association with ICDs in patients with PD (PwPs) has not been investigated. This study aimed to assess the relationship between serum UA levels, the uric acid to creatinine ratio (UA/Cr), and ICD prevalence in PwPs. Materials and Methods: We enrolled 172 PwPs hospitalized for follow-up or treatment modification. ICDs were screened with the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP). Clinical data included demographics, disease severity, motor and non-motor symptoms, and dopaminergic treatment. Fasting serum UA and UA/Cr were determined. Results: ICDs were present in 24.42% of patients, most commonly binge eating and compulsive buying. PwPs with ICDs had longer disease duration, more motor complications, higher dopaminergic doses, and more frequent dopamine agonist use. No relationship was found between absolute UA and overall ICD occurrence. However, lower UA/Cr was observed in patients with hypersexuality and pathological gambling, as well as in those with multiple ICD subtypes. Logistic regression confirmed that higher UA/Cr reduced the odds of hypersexuality (OR = 0.55; 95% CI 0.31–0.98) and multiple ICDs (OR = 0.33; 95% CI 0.13–0.84). As a secondary finding, lower absolute UA was observed in PwPs with more advanced motor symptoms, motor complications, depressive symptoms, and cognitive impairment. Conclusions: Lower UA/Cr was selectively associated with specific ICD subtypes and with the coexistence of multiple ICDs in patients with PD. UA/Cr may serve as a marker of ICD heterogeneity. Confirmation in larger, prospective cohorts is needed to establish clinical relevance.

Background: Multiple sclerosis (MS) and autoimmune diseases (AIDs) share immunological underpinnings, leading to frequent co-occurrence. This study investigated the prevalence of AIDs among Polish patients with MS (PwMSs) and its potential effects on disease characteristics. The aims were to compare clinical and demographic characteristics between PwMSs with and without coexisting AIDs. Methods: A retrospective analysis was conducted on data from 580 PwMSs who were treated at the Department of Neurology, University Clinical Center in Katowice, Poland, between February 2018 and August 2023. Variables analyzed included age, sex, MS type, disease duration, treatment, Expanded Disability Status Scale (EDSS) scores, thyroid-stimulating hormone (TSH), and vitamin D3 serum concentrations. Results: AID was identified in 16.9% of PwMSs (n = 98). Compared with PwMSs without AIDs, PwMSs with AIDs exhibited significantly higher mean age (44.61 ± 11.40 vs. 42.24 ± 12.27 years; p = 0.0151), longer disease duration (10.77 ± 6.72 vs. 9.56 ± 7.19 years; p = 0.0102), and higher EDSS scores (2.97 ± 1.43 vs. 2.89 ± 1.84; p = 0.0261). Among PwMSs, the prevalence of AIDs was significantly higher in females (20.24%) compared to males (8.13%; p = 0.0022), and strongly associated with the relapsing-remitting MS subtype (p = 0.0352). Autoimmune thyroid diseases were markedly the most prevalent in PwMSs (hypothyroidism 7.24%). Conclusions: PwMSs with AIDs exhibit distinct characteristics, including older age, increased disease duration, and greater disability. Thyroid disorders are notably the most prevalent AIDs among PwMSs. These findings underscore the intricate interplay between AIDs and MS and highlight the necessity for further research into their long-term impact.