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Background: 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.
Method: 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)).
Results: PFH patients showed significantly heightened sweat secretion over time compared to controls (p = 0.006), with highest quantities during the TSST-VR. In both groups, sweating (p < 0.001), maximum cortisol levels (p = 0.002), feelings of stress (p < 0.001), and heart rate (p < 0.001) but not sAA (p = 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 (pall > 0.131).
Conclusion: 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.
In the present study, we tested whether processing information in the context of an ancestral survival scenario enhances episodic memory performance in older adults and in stroke patients. In an online study (Experiment 1), healthy young and older adults rated words according to their relevance to an ancestral survival scenario, and subsequent free recall performance was compared to a pleasantness judgment task and a moving scenario task in a within-subject design. The typical survival processing effect was replicated: Recall rates were highest in the survival task, followed by the moving and the pleasantness judgment task. Although older adults showed overall lower recall rates, there was no evidence for differences between the age groups in the condition effects. Experiment 2 was conducted in a neurological rehabilitation clinic with a sample of patients who had suffered from a stroke within the past 5 months. On the group level, Experiment 2 revealed no significant difference in recall rates between the three conditions. However, when accounting for overall memory abilities and executive function, independently measured in standardized neuropsychological tests, patients showed a significant survival processing effect. Furthermore, only patients with high executive function scores benefitted from the scenario tasks, suggesting that intact executive function may be necessary for a mnemonic benefit. Taken together, our results support the idea that the survival processing task – a well-studied task in the field of experimental psychology – may be incorporated into a strategy to compensate for memory dysfunction.
