Abstract
Rationale
In patients suffering from metastatic carcinoid tumors, chronic disturbances of serotonergic metabolism are frequently present. Serotonin is supposed to influence a range of cognitive functions.
Objectives
The present study evaluated the cognitive performance of carcinoid patients.
Methods
In 14 patients with proven carcinoid syndrome, neuropsychological functioning was studied. Visual search, sustained attention, set shifting ability and spatial working memory were assessed using tests from the CANTAB neuropsychological battery. This was compared with the performance of matched healthy controls.
Results
Plasma tryptophan levels were lower than controls. Patients showed an enhanced ability to learn new stimulus–response associations. Sustained visual attention, however, was impaired.
Conclusion
Cognitive patterns were different from those found in depressive patients and partly mimicked those found in tryptophan depletion experiments. Further investigation has to point out the role of serotonergic changes in the accomplishment of affective states.
Similar content being viewed by others
References
Altman HJ, Normile HJ (1986) Enhancement of the memory of a previously learned aversive habit following pre-test administration of a variety of serotonergic agonists in mice. Psychopharmacology 90:24–27
Beats BC, Sahakian BJ, Levy R (1996) Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychol Med 26:591–603
Bender DA (1983) Biochemistry of tryptophan in health and disease. Mol Aspects Med 6:101–197
Blokland A, Lieben C, Deutz NE (2002) Anxiogenic and depressive-like effects, but no cognitive deficits, after repeated moderate tryptophan depletion in the rat. J Psychopharmacol 16:39–49
Coull JT, Sahakian BJ, Middleton HC, Young AH, Park SB, McShane RH, Cowen PJ, Robbins TW (1995) Differential effects of clonidine, haloperidol, diazepam and tryptophan depletion on focused attention and attentional search. Psychopharmacology 121:222–230
Craft S, Asthana S, Newcomer JW, Wilkinson CW, Matos IT, Baker LD, Cherrier M, Lofgreen C, Latendresse S, Petrova A, Plymate S, Raskind M, Grimwood K, Veith RC (1999) Enhancement of memory in Alzheimer disease with insulin and somatostatin, but not glucose. Arch Gen Psychiatry 56:1135–1140
Fontana DJ, Daniels SE, Henderson C, Eglen RM, Wong EHF (1995) Ondansetron improves cognitive performance in the Morris water maze spatial navigation task. Psychopharmacology 87:409–417
Fray PJ, Robbins TW, Sahakian BJ (1997) Neuropsychiatric applications of CANTAB. Int J Geriatr Psychiatry 11:329–336
Grier JB (1971) Nonparametric indexes for sensitivity and bias: computing formulas. Psychol Bull 75:424–429
Hanna SM (1965) Carcinoid syndrome associated with psychosis. Postgrad Med J 41:566–567
Jaehde U, Masereeu R, de Boer AG, Fricker G, Nagelkerke JF, Vonderscher J, Breimer DD (1994) Quantification and visualisation of the transport of octreotide, a somatostatin analogue, across monolayers of cerebrovascular endothelial cells. Pharm Res 11:442–448
Kema IP, Schellings AM, Hoppenbrouwers CJ, Rutgers HM, de Vries EG, Muskiet FA (1993) High performance liquid chromatographic profiling of tryptophan and related indoles in body fluids and tissues of carcinoid patients. Clin Chim Acta 221:143–158
Liu SK, Chiu CH, Chang CJ, Hwang TJ, Hwu HG, Chen WJ (2002) Deficits in sustained attention in schizophrenia and affective disorders: stable versus state-dependent markers. Am J Psychiatry 159:975–982
Luciana M, Collins PF, Depue RA (1998) Opposing roles for dopamine and serotonin in the modulation of human spatial working memory functions. Cerebral Cortex 8:218–226
Major LF, Brown GL, Wilson WP (1973) Carcinoid and psychiatric symptoms. South Med J 66:787–790
Park SB, Coull JT, McShane RH, Young AH, Sahakian BJ, Robbins TW, Cowen PJ (1994) Tryptophan depletion in normal volunteers produces selective impairments in learning and memory. Neuropharmacology 33:575–588
Patchell RA, Posner JB (1986) Neurologic complications of carcinoid. Neurology 36:745–749
Purcell R, Maruff P, Kyrios M, Pantelis C (1997) Neuropsychological function in young patients with unipolar major depression. Psychol Med 27:1277–1285
Riedel WJ, Klaassen T, Deutz NE, van Someren A, van Praag HM (1999) Tryptophan depletion in normal volunteers produces selective impairment in memory consolidation. Psychopharmacology 141:362–369
Rogers RD, Blackshaw AJ, Middleton HC, Matthews K, Hawtin K, Crowley C, Hopwood A, Wallace C, Deakin JF, Sahakian BJ, Robbins TW (1999) Tryptophan depletion impairs stimulus-reward learning while methylphenidate disrupts attentional control in healthy young adults: implications for the monoaminergic basis of impulsive behaviour. Psychopharmacology 146:482–491
Rubinsztein JS, Rogers RD, Riedel WJ, Mehta MA, Robbins TW, Sahakian BJ (2001) Acute dietary depletion impairs maintenance of "affective set" and delayed visual recognition in healthy volunteers. Psychopharmacology 154:319–326
Schmand B, Bakker D, Saan R, Louman J (1991) The Dutch reading test for adults: a measure of premorbid intelligence level. Tijdschr Gerontol Geriatr 22:15–19
Schmitt JA, Jorissen BL, Sobczak S, van Boxtel MP, Hogervorst E, Deutz NE, Riedel WJ (2000) Tryptophan depletion impairs memory consolidation but improves focussed attention in healthy young volunteers. J Psychopharmacol 14:21–29
Trivedi S (1984) Psychiatric symptoms in carcinoid syndrome. J Indian Med Assoc 82:292–294
Young SN, Smith SE, Pihl RO, Ervin FR (1985) Tryptophan depletion causes a rapid lowering of mood in normal males. Psychopharmacology 87:173–177
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Russo, S., Nielen, M.M.A., Boon, J.C. et al. Neuropsychological investigation into the carcinoid syndrome. Psychopharmacology 168, 324–328 (2003). https://doi.org/10.1007/s00213-003-1455-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00213-003-1455-5