{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:38:06Z","timestamp":1781080686968,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2010,9,18]],"date-time":"2010-09-18T00:00:00Z","timestamp":1284768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Inher Metab Disea"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although patients with low cerebrospinal fluid (CSF) serotonin metabolite levels have been reported, inborn errors of the rate\u2010limiting enzyme of serotonin synthesis (tryptophan hydroxylase, TPH) have not been described so far. In this study we aimed to evaluate CSF alterations of the serotonin metabolite 5\u2010hydroxyindolacetic acid (5\u2010HIAA) in patients with neurological disorders and to explore a possible TPH deficiency in some of them. A total of 606 patients (286 males, 320 females, mean age 4 years and 6 months, SD 5 years and 7 months) underwent CSF analysis of neurotransmitter metabolites by reverse phase high performance liquid chromatography. Results were compared with values established in a control population. Patients\u2019 medical records were reviewed to determine diagnosis and clinical features. A primary defect of biogenic amines was genetically investigated in indicated patients. Low 5\u2010HIAA was seen in 19.3%. Of these, 22.2% showed inborn errors of metabolism (mitochondrial disorders being the most frequent at 10.2% of low 5\u2010HIAA patients) and neurogenetic conditions. Other relatively frequent conditions were pontocerebellar hypoplasia (4.3%), Rett syndrome (4.3%), and among congenital nonetiologically determined conditions, epilepsy including epileptic encephalopathies (26.4%), leukodystrophies (6.8%), and neuropsychiatric disturbances (4.2%). Mutational analysis of the <jats:italic>TPH2<\/jats:italic> gene, performed in five candidate patients, was negative. Although frequency of secondary alteration of 5\u2010HIAA was relatively high in patients with neurological disorders, this finding was more frequently associated with some neurometabolic disorders, epileptic encephalopathies, and neuropsychiatric disturbances. No inborn errors of TPH were found. Due to serotonin's neurotrophic role and to ameliorate symptoms, a supplementary treatment with 5\u2010hydroxytriptophan would seem advisable in these patients.<\/jats:p>","DOI":"10.1007\/s10545-010-9200-9","type":"journal-article","created":{"date-parts":[[2010,9,17]],"date-time":"2010-09-17T08:01:58Z","timestamp":1284710518000},"page":"803-809","source":"Crossref","is-referenced-by-count":34,"title":["Cerebrospinal fluid alterations of the serotonin product, 5\u2010hydroxyindolacetic acid, in neurological disorders"],"prefix":"10.1002","volume":"33","author":[{"given":"Elisa","family":"De Grandis","sequence":"first","affiliation":[{"name":"Neurology Department Hospital Sant Joan de Deu Barcelona Spain"},{"name":"Department of Child Neuropsychiatry, G. 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