{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:48:55Z","timestamp":1792788535902,"version":"4.5.0"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"State Rhineland-Palatinate, Germany","award":["Trier University Research Priority Program \u201cPsychobiology of Stress\u201d"],"award-info":[{"award-number":["Trier University Research Priority Program \u201cPsychobiology of Stress\u201d"]}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["Open Access Publishing funding programme"],"award-info":[{"award-number":["Open Access Publishing funding programme"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hyperhidrosis (excessive sweating, OMIM %114110) is a complex disorder with multifactorial causes. Emotional strains and social stress increase symptoms and lead to a vicious circle. Previously, we showed significantly higher depression scores, and normal cortisol awakening responses in patients with primary focal hyperhidrosis (PFH). Stress reactivity in response to a (virtual) Trier Social Stress Test (TSST-VR) has not been studied so far. Therefore, we measured sweat secretion, salivary cortisol and alpha amylase (sAA) concentrations, and subjective stress ratings in affected and non-affected subjects in response to a TSST-VR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>In this pilot study, we conducted TSST-VRs and performed general linear models with repeated measurements for salivary cortisol and sAA levels, heart rate, axillary sweat and subjective stress ratings for two groups (diagnosed PFH (n = 11), healthy controls (n = 16)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PFH patients showed significantly heightened sweat secretion over time compared to controls (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006), with highest quantities during the TSST-VR. In both groups, sweating (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), maximum cortisol levels (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), feelings of stress (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and heart rate (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) but not sAA (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.068) increased significantly in response to the TSST-VR. However, no differences were detected in subjective ratings, cortisol concentrations and heart rate between PFH patients and controls (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>all<\/jats:sub>\n                      &gt; 0.131).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with diagnosed PFH showed stress-induced higher sweat secretion compared to healthy controls but did not differ in the stress reactivity with regard to endocrine or subjective markers. This pilot study is in need of replication to elucidate the role of the sympathetic nervous system as a potential pathway involved in the stress-induced emotional sweating of PFH patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0272247","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T14:10:23Z","timestamp":1659449423000},"page":"e0272247","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Real sweating in a virtual stress environment: Investigation of the stress reactivity in people with primary focal hyperhidrosis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9581-516X","authenticated-orcid":true,"given":"Andrea B.","family":"Schote","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Dietrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian E.","family":"Linden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Dzionsko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura De Los Angeles","family":"Molano Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Winnikes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Zimmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Domes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jobst","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"pone.0272247.ref001","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/S0278-5846(02)00297-X","article-title":"Hyperhidrosis in social anxiety disorder","volume":"26","author":"JRT Davidson","year":"2002","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"pone.0272247.ref002","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jaad.2003.12.040","article-title":"US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey","volume":"51","author":"DR Strutton","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"pone.0272247.ref003","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1055\/s-2004-822835","article-title":"Hyperhidrose\u2014Ursachen und aktuelle Behandlungsm\u00f6glichkeiten","volume":"80","author":"M Sonntag","year":"2004","journal-title":"ZFA\u2014Zeitschrift f\u00fcr Allgemeinmedizin"},{"key":"pone.0272247.ref004","doi-asserted-by":"crossref","first-page":"e0244565","DOI":"10.1371\/journal.pone.0244565","article-title":"Genome-wide linkage analysis of families with primary hyperhidrosis","volume":"15","author":"AB Schote","year":"2020","journal-title":"PLOS ONE"},{"key":"pone.0272247.ref005","first-page":"464","article-title":"Schwitzen und Hyperhidrose (gesteigerte Schweisssekretion)","volume":"18","author":"R. 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