Bipolar disorder (BD) is associated with systemic toxicity, represented by changes in biomarkers associated with mood episodes, leading to neurological damage, which may reflect cognitive functions and functionality and the progression of the disease. We aimed to analyze the effect of four biomarkers, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and thiobarbituric acid reactive substances (TBA-RS), related to oxidative stress in BD and to correlate them with cognitive functions and functionality. We studied 50 bipolar types I/II patients in the euthymic phase, which was divided into two subgroups with 25 patients each (≤ 3 years and ≥ 10 years of diagnosis, from the first episode of mania) and 25 control patients. To analyze frontal cognitive functions and functionality, we used the Frontal Assessment Battery (FAB) and Functioning Assessment Short Test (FAST) tests, respectively. The scores of the FAST and FAB tests showed an increase and decrease respectively, in both bipolar groups, when compared to the control group, demonstrating impairment in cognitive functions and functionality since the disease onset. In addition, changes occurred in all six domains of the FAST test, and in four domains of the FAB test in bipolar patients when compared to the control group. Regarding oxidative stress biomarkers, we did not find changes in SOD and GSH-Px activities; however, a significant increase in CAT activity and lipid peroxidation was observed in both groups, although the patients were euthymic and medicated. These results allow us to raise the hypothesis that since the beginning of the disease, the euthymic bipolar patient has presented a level of oxidative stress, which gets worse with the evolution of the disease, promoting impairments in the frontal cognitive functions and functionality gradually.

Objective: In this article, we focus on assessing two key predictors of outcomes in Bipolar Disorder (BD): cognition and functionality performance, and researching for a correlation between them. Methods: Subjects were patients with BD in the euthymic phase (n=50), and healthy controls (n=25). Psychosocial functioning was evaluated using the Functioning Assessment Short Test (FAST), and the same group underwent the Frontal Assessment Battery (FAB) to assess the Executive Functions (EF). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chisquare test. To verify a correlation between FAB and FAST tests, we used the Spearman Correlation Coefficient. Results: Patients with BD showed higher FAST total scores (24.60±11.09) than healthy controls (9.80±5.94) (p< 0.001), and patients with BD showed lower FAB total scores (13.56±2.81) than healthy control (15.72±1.64) (p<0.001). Associated with these results, bipolar patients showed higher FAST scores in all domains predominantly with moderate impairment (score 21-40), and also lower scores in the following three domains: conceptualization, sensitivity to interference, and inhibitory control in the FAST test (p<0.05). The correlation between the variables FAB and FAST presented a moderate intensity (r 2 = -0.539). Conclusion: This study reinforced the impact of BD in functionality and the EF, demonstrating alterations in several domains: social, occupational, and cognitive functions impairment. Understanding them is crucial for these patients, which increases the possibility of rehabilitation and the response to treatment. I. INTRODUCTIONBipolar Disorder (BD) is a chronic and severe disease that affects approximately 1.1% of the world population and is associated with a high rate of morbidity, mortality, suicide, and clinical comorbidities [1]. Its pathophysiology is complex, multifactorial, and is not yet fully understood, being influenced by genetic and environmental factors [2]. Multiple changes occur in the brain, such as neuroplasticity, neurotransmission failures, apoptosis, activation in the immune-inflammatory process, and more recently, oxidative stress [3]. These events involve a pathological reorganization in the brain and therefore are associated with morphological modifications, such as the reduced volume of the Luiz Arthur Rangel Cyrino et. al.

In this study, we focus on assessing two key predictors and outcomes in Bipolar Disorder (BD), which are: cognition and functionality performance, dividing them into two subgroups, and then researching for a correlation between them. Methods; Fifty patients with BD in a euthymic phase were divided into two subgroups (≤ 3 years (n=25) and ≥ 10 years (n=25) of the disease) and were then compared with healthy controls (n=25). Psychosocial functioning was assessed using the Short Functionality Assessment Test (FAST), and the Frontal Assessment Battery (FAB) test to assess frontal cognitive functions. Clinical and sociodemographic characteristics were analyzed using unilateral variance analysis, or the chi-square test. In order to verify the correlation between the FAB and FAST tests, Spearman's correlation coefficient test was used Results: Both subgroups of euthymic patients had higher FAST total scores than the healthy control group (9.80 ± 5.94). The groups with ≤ 3 years (20.63 ± 8.21), and ≥ 10 years (27.80 ± 12.50) of the disease presented(p<0.001). Associated with these results, bipolar patients had higher FAST scores in all domains, predominantly with moderate impairment (score 21-40), and lower scores in the following four FAB test domains: conceptualization, sensitivity to interference, inhibitory control, and motor series (p<0.05). The correlation between the FAB and FAST tests showed moderate intensity (r 2 = -0.539). Conclusion: This study reinforced the impact of BD on functionality and frontal cognitive functions, demonstrating changes in several domains, and impairment in social, occupational, and cognitive functions in patients with different times of disease onset. Understanding all factors is essential for these patients, which increases the possibility of rehabilitation and response to treatment.

Bipolar Disorder (BD) is associated with systemic toxicity, represented by changes in the biomarkers, associated with mood episodes, leading to neurological damage, which may reflect on cognitive functions and functionality, and the progression of the disease. We aimed to analyze the effect of four biomarkers superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) enzymes, and thiobarbituric acid reactive substances (TBA-RS) related to oxidative stress in BD and to correlate them with cognitive functions and functionality. We studied 50 bipolar patients type I/II, in the euthymic phase, which was divided into two subgroups with 25 patients, (≤3 years and ≥10 years of diagnosis, from the first episode of mania), and 25 control patients. To analyze frontal cognitive functions and functionality, we used the tests: Frontal Assessment Battery (FAB) and Functioning Assessment Short Test (FAST), respectively. The FAST test scores results were ≤3 years (20.63±8.21), ≥10 years (27.80±12.50), and control group (9.80±5.94), p<0.001. Changes occurred in all domains. The FAB test scores were ≤3 years (14.64±2.48), ≥10 years (12.44±2.78), and control group (15.84±1.55), p<0.001, and showed lower scores in four domains. The oxidative stress showed an increase in TBA-RS levels: ≤3 years (3.18±1.17), ≥10 years (3.01±1.03) compared to the control group (1.62±0.28), p<0.0001; and in the CAT enzyme activity we found, ≤3 years (8.10±4.18), ≥10 years (9.41±4.95), compared to the control group (3.47±0.77), p<0.0001. Even during the euthymic phase, bipolar patients showed and maintained an increase in CAT activity and lipid peroxidation with significant changes in the FAB and FAST tests in different groups of patients, demonstrating impairment in cognitive functions and functionality since disease onset.

Introdução: A sinestesia, que possui uma prevalência de 4%, é uma condição neurológica em que um único estímulo elicia experiências adicionais a outro sentido sensorial, que pode ser: visual, auditivo, olfativo, gustativo e tátil. Essa condição não está incluída no Manual Diagnóstico e Estatístico de Transtornos Mentais 5ª edição (DSM-5), entretanto suas bases neurológicas podem estar atreladas a algumas disfunções comportamentais presentes em outros transtornos, como no transtorno do espectro do autismo (TEA). Objetivo: Realizar uma revisão de literatura sobre a sinestesia e sua possível correlação com o TEA. Materiais e métodos: O levantamento bibliográfico foi feito por meio de consultas às bases de dados eletrônicas PubMed, ScienceDirect, SciELO, Google Acadêmico e ResearchGate, sendo incluídos artigos e livros publicados nas línguas portuguesa e inglesa, entre os anos 1995 e 2015, que documentassem sobre a sinestesia e o TEA. Resultados: Para compor esta revisão, 37 artigos e 4 livros, nacionais e internacionais, foram incluídos. Os estudos mostraram que a prevalência da sinestesia é maior em indivíduos autistas. Outros resultados apontam semelhanças nas bases neurológicas e genéticas envolvidas no TEA e na sinestesia, que explicam o processamento perceptual sensorial alterado em ambos. Conclusão: Com base em diferentes estudos, conclui-se que a sinestesia e o TEA podem apresentar uma correlação e que seus aspectos apontam um desafio para futuras pesquisas.