Person: İŞAK, BARIŞ
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İŞAK
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BARIŞ
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Publication Metadata only A neurophysiological approach to the complex organisation of the spine: F-wave duration and the cutaneous silent period in restless legs syndrome(ELSEVIER IRELAND LTD, 2011) İŞAK, BARIŞ; Isak, Baris; Uluc, Kayihan; Salcini, Celal; Agan, Kadriye; Tanridag, Tulin; Us, OnderObjective: It is generally accepted that F-wave duration (FWD) and the cutaneous silent period (CSP) are influenced by diminished central inhibition. The aim of this study was to diagnose patients of restless legs syndrome (RLS) with the help of FWD and/or CSP parameters. Methods: In all, 24 patients with primary RLS were compared with 31 age-and sex-matched controls. The participants were evaluated based on nerve conduction study (NCS), F-wave parameters (minimum, maximum and mean latency; chronodispersion, persistence and duration; and the ratio of the mean FWD to compound muscle action potential (CMAP) duration), CSP (latency, duration and the ratio of lower-extremity (LE) to upper-extremity (UE) duration that is, silent period ratio (SPR)), the expiration to inspiration ratio (E/I) and sympathetic skin response (SSR). Results: There were not any significant differences in NCS, E/I or SSR between the patients and controls. However, FWD was prolonged (P < 0.0001 for UE and LE) and FWD/CMAP duration was increased in upper and lower extremities (P < 0.001 for UE and P < 0.0001 for LE). Further, CSP latencies in UE (P = 0.030) and LE (P < 0.001) were prolonged, and CSP duration and SPR were significantly reduced in the patient group (P < 0.0001). Conclusions: As both NCS and autonomic test results were in the normal range, abnormalities in FWD and CSP parameters were attributed to the dysfunction of different interneuron groups in the spine. Significance: The use of FWD and CSP could aid in the diagnosis of RLS patients in whom conventional electrophysiological procedures are ineffective. (C) 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.Publication Metadata only Cutaneous silent period recordings in demyelinating and axonal polyneuropathies(ELSEVIER IRELAND LTD, 2015) İŞAK, BARIŞ; Lopergolo, Diego; Isak, Baris; Gabriele, Maria; Onesti, Emanuela; Ceccanti, Marco; Capua, Gelsomina; Fionda, Laura; Biasiotta, Antonella; Di Stefano, Giulia; La Cesa, Silvia; Frasca, Vittorio; Inghilleri, MaurizioObjective: To investigate the cutaneous silent period (CSP), a spinal inhibitory reflex mainly mediated by A-delta fibres, in demyelinating and axonal polyneuropathy (PNP) and evaluate whether CSP parameters differ between patients with and without neuropathic pain. Methods: Eighty-four patients with demyelinating PNP, 178 patients with axonal PNP and 265 controls underwent clinical examination, DN4 questionnaire, standard nerve conduction study, motor-root stimulation and CSP recordings from abductor digiti minimi. We calculated the afferent conduction time of CSP (a-CSP time) with the formula: CSP latency - root motor evoked potential latency. Results: In the demyelinating PNP group the a-CSP time was significantly longer; in the axonal PNP group, CSP duration was shorter than the demyelinating group (p = 0.010) and controls (p = 0.001). CSP parameters were not different between patients with and without neuropathic pain. Conclusions: The abnormality of a-CSP time in the demyelinating PNP group suggests the crucial role of A-delta fibres in the mechanism of CSP; the shorter CSP duration in the axonal PNP group supports the strong influence of the number of axons on this parameter. Conclusions: Our study suggests that neuropathic pain could be related to pathophysiological mechanisms differing from mere A-delta fibre loss. Significance: CSP evaluation is effective in detecting A-delta fibre dysfunction in axonal as well as demyelinating PNP. (C) 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.Publication Metadata only Neurophysiologic assessment of small fibre damage in chemotherapy-induced peripheral neuropathy(ELSEVIER IRELAND LTD, 2021) İŞAK, BARIŞ; Isak, Baris; Tankisi, Hatice; Pugdahl, Kirsten; Ventzel, Lise; Finnerup, Nanna Brix; Fuglsang-Frederiksen, AndersObjective: In patients with chemotherapy-induced peripheral neuropathy (CIPN), demonstration of small fibre (SF) damage is important to understand chronic late effects. Methods: Thirty patients having complaints compatible with possible CIPN following treatment with oxaliplatin or docetaxel were compared with 27 healthy subjects. All subjects were evaluated with quantitative sensory testing (QST) assessing SF function and laser evoked potentials (LEP). In addition, SF-damage was assessed using cutaneous silent periods evoked with electrical (El-CSP) and laser (Ls-CSP) stimuli. Results: For LEP, N2P2 amplitudes were significantly smaller in patients than controls in both upper (P = 0.007) and lower extremities (P = 0.002), and the N1 amplitude in upper extremities of patients were significantly smaller than in controls (P = 0.001). SF-QST, LEP, Ls-CSP, and El-CSP were abnormal in 10 (33.3%), 16 (53.3%), 19 (63.3%), and 24 (80%) of CIPN patients, respectively. Conclusions: In patients with possible CIPN, El-CSP and Ls-CSP were more often abnormal than LEP and QST. This is probably because El-CSP and Ls-CSP inform mainly about peripheral nociceptive fibres, while LEP and QST inform about peripheral and central nociceptive pathways together. Significance: LEP and QST are established methods to detect SF-damage. El- and Ls-CSP might help clinicians in diagnosing SF-damage. (C) 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.