Psychiatric and cognitive function in patients with serotonin producing neuroendocrine tumors

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Introduction: Cognitive and psychiatric problems are common in cancer patients, but literature in patients with neuroendocrine tumors (NET) is scarce. Peripheral serotonin overproduction by the tumor, clinically manifesting as carcinoid syndrome, is hypothesized to be related to cognitive and psychiatric problems, through depletion of serotonin’s precursor tryptophan.

Aim(s): We investigate cognitive and psychiatric function in NET patients and the association with measures of peripheral serotonin production and tryptophan.

Materials and methods: 81 patients with a serotonin-producing metastatic small intestine NET underwent standardized neuropsychological and psychiatric assessment. Blood and urinary samples were collected to determine levels of serotonin, its precursor tryptophan, and metabolite (5-HIAA). Multivariate normative comparison was applied to determine the prevalence of cognitive impairment. Separate linear regressions of serotonin, tryptophan, and 5-HIAA levels on cognitive function, depressive symptoms, and anxiety symptoms were performed, corrected for age, sex, education and/or duration of illness.

Conference:

Presenting Author: Tesselaar M

Authors: Luijendijk M, Tesselaar M, van Rossum H, Korse C, Verbeek W,

Keywords: Neuroendocrine neoplasm, carcinoid syndrome, cognitive functioning, depression, anxiety, serotonin, tryptophan, 5-HIAA,