Person: İŞAK, BARIŞ
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İŞAK
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BARIŞ
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Publication Metadata only Madras motor neuron disease in Turkey(INFORMA HEALTHCARE, 2009) İŞAK, BARIŞ; Isak, Baris; Uluc, Kayihan; Tanridag, Tulin; Ozsahin, Selda; Dengler, Reinhard; Us, Onder; Petri, SusanneWe present a 19-year-old female patient complaining of hoarseness and eyelid drooping. The neurological examination and laboratory investigations including genetic, radiological and electrophysiological evaluations were consistent with a juvenile-onset, predominantly bulbar, motor neuron disease with sensorineural hearing loss. The syndrome fulfilled the diagnostic criteria of Madras Motor Neuron Disease (MMND). Very few cases with MMND have been reported to date, and the majority are from south-eastern Asia. This is the first case reported from Turkey and indicates that the disease is not only regional but may also occur on the basis of rare de novo mutations.Publication Metadata only Leukoencephalopathy with brain stem and spinal cord involvement and high lactate: A genetically proven case with distinct MRI findings(ELSEVIER SCIENCE BV, 2008) İŞAK, BARIŞ; Uluc, Kayihan; Baskan, Ozdil; Yildirim, Kadriye Agan; Ozsahin, Selda; Koseoglu, Mesrure; Isak, Baris; Scheper, G. C.; Gunal, Dilek Ince; van der Knaap, M. S.Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL) is a recently described disorder with autosomal recessive mode of inheritance. Lately, mutations in the DARS2 gene, which encodes mitochondrial aspartyl-tRNA synthetase, have been found as the underlying defect. We report a 19-year-old male patient with cerebellar, pyramidal and dorsal column dysfunctions and specific magnetic resonance imaging (MRI) and characteristic magnetic resonance spectroscopy (MRS) abnormalities. The patient was compound-heterozygous for two mutations in DARS2. MRI showed selective involvement of cerebral and cerebellar white matter and superior and inferior cerebellar peduncles, without contrast enhancement. The U-fibers were spared. The sensory and the pyramidal tracts were affected over their entire length. Involvement of the intraparenchymal trajectories of the trigeminal nerves and mesencephalic trigeminal tracts was demonstrated. In the spinal cord, signal abnormalities were identified in the dorsal columns and the lateral corticospinal tracts. Proton-MRS of the frontal and cerebellar white matter showed elevated lactate, reduced N-acetylaspartate, increased myoinositol and mildly elevated choline. In LBSL, distinct MRI findings should lead to the diagnosis, which can be confirmed by the analysis of the disease gene DARS2. (c) 2008 Elsevier B.V. All rights reserved.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 Does the Provocation Maneuvers Increase the Sensitivity of Sensory Nerve Conduction Studies in Diagnosis of Carpal Tunnel Syndrome?(GALENOS YAYINCILIK, 2012-12-15) İŞAK, BARIŞ; Aktas, Ilknur; Sunter, Gulin; Uluc, Kayihan; Isak, Baris; Tanridag, Tulin; Akyuz, Gulseren; Us, OnderObjective: The aim of this study was to determine the sensitivity of sensory nerve conduction study (NCS) parameters in the diagnosis of carpal tunnel syndrome (CTS) and to explore if the use of provocative maneuvers improves their sensitivity Materials and Methods: In this prospective study, we included 85 consecutive cases (135 hands) that had signs and symptoms of CTS, and 100 control hands. Sensory NCS was performed in the neutral position and then the wrist was placed in flexion and 90 degrees of extension for 1 min. Onset and peak latencies and velocities, negative peak duration and area, and peak amplitude were measured. Results: The most sensitive parameters were onset latency (77%), and onset (72%) and peak velocities (72%) in neutral position. The flexion maneuver did not increase their sensitivity, however, negative peak area (10%) and amplitude (24%) sensitivities were higher in extended position than in neutral position. Conclusion: The most sensitive NCS parameters were onset latency, and onset and peak velocities in neutral position. The extension maneuver was more sensitive than neutral position. Turk J Phys Med Rehab 2012;58:307-71.Publication Metadata only Where Is the Core of the Volcano? The Undetermined Origin of Primary Restless Legs Syndrome(TAYLOR & FRANCIS LTD, 2011) İŞAK, BARIŞ; Isak, Baris; Agan, Kadriye; Ergun, Aslihan; Cakkalkurt, Aslican; Uluc, Kayihan; Tanridag, Tulin; Us, OnderAn association between small fiber neuropathy and primary Restless Legs Syndrome (RLS) is suggested since both of them share common characteristics. Our aim was to investigate the existence of autonomic neuropathy on the basis of autonomic tests. The patients and the age-matched controls were evaluated with Neuropathy Symptom Profile and Autonomic Symptom Profile, nerve conduction studies (NCS), and autonomic tests. Patients suffered from neuropathic and autonomic complaints obviously. There was no significant difference for NCS, heart rate variability tests, and sympathetic skin responses (SSRs) among patients and controls. Since both the NCSs and the autonomic tests were within normal, the complaints were considered to be the consequences of the problem in sensory integration due to the dysfunction of the caudal diencephalic All group, rather than a neuropathic process. The cardiac autonomic imbalance possibly emerges as a consequence of arousal periods prior to or during the Periodic Leg Movements (PLM) episodes during sleep, but not due to autonomic neuropathy.Publication Metadata only Medial plantar and dorsal sural nerve conduction studies increase the sensitivity in the detection of neuropathy in diabetic patients(ELSEVIER IRELAND LTD, 2008) İŞAK, BARIŞ; Uluc, Kayihan; Isak, Baris; Borucu, Deniz; Temucin, Cagri Mesut; Cetinkaya, Yilmaz; Koytak, Pinar Kahraman; Tanridag, Tulin; Us, Onderobjective: Clinical utility of nerve conduction studies (NCS) of the medial plantar and dorsal sural nerves in the early detection of polyneuropathy have already been shown separately. However, at present, there is no data about the combined assessment of these two nerves in distal sensory neuropathy. In the present study, we aimed to evaluate the medial plantar and dorsal sural NCS in a group of diabetic patients with distal sensory neuropathy (DSN) and in healthy controls. Methods: Thirty healthy and 30 diabetic adult patients were included. In all subjects, peripheral motor and sensory NCS were performed bilaterally with surface electrodes on the lower limbs including medial plantar and dorsal sural nerves. In addition, motor and sensory nerves were studied unilaterally on the upper limb. Results: In all patients, nerve action potential (NAP) amplitudes of sural and superficial peroneal nerves were within normal ranges, but in the patient group mean value was significantly lower than in the controls. Among clinically defined 30 DSN patients, medial plantar NAP amplitude was abnormal in 18 (60%) and dorsal sural nerve amplitude was abnormal in 13 (40%) of the patients bilaterally. Additionally, the onset NCV of the dorsal sural nerve was significantly slower in patients than controls (P = 0.038). Evaluation of both of these nerves increased the sensitivity up to 70% in the detection of neuropathy. Conclusions: Bilateral NCS assessment of both of the medial plantar and dorsal sural nerves together increases the rate of diagnosis of diabetic distal sensory neuropathy compared to assessment of either of these nerves. Significance: Assessment of medial plantar in addition to dorsal sural NCS together increases the sensitivity in the detection of neuropathy and allows earlier diagnosis, especially when routine NCS are normal. (c) 2008 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.Publication Metadata only ASSESSMENT OF SYMPTOMATIC DIABETIC PATIENTS WITH NORMAL NERVE CONDUCTION STUDIES: UTILITY OF CUTANEOUS SILENT PERIODS AND AUTONOMIC TESTS(WILEY, 2011) İŞAK, BARIŞ; Koytak, Pinar Kahraman; Isak, Baris; Borucu, Deniz; Uluc, Kayihan; Tanridag, Tulin; Us, OnderEstablished electrophysiological methods have limited clinical utility in the diagnosis of small-fiber neuropathy (SFN). In this study, diabetic patients with clinically diagnosed SFN were evaluated with autonomic tests and cutaneous silent periods (CSPs). Thirty-one diabetic patients with clinically suspected SFN and normal nerve conduction studies were compared with 30 controls. In the upper extremities (UE), the CSP parameters did not differ statistically between the patient and control groups, whereas, in the lower extremities (LE), patients had prolonged CSP latencies (P = 0.018) and shortened CSP durations (P < 0.001). The sensitivity of the CSP duration was 32.6%, and the specificity was 96.7%. The expiration-to-inspiration ratios and amplitudes of the sympathetic skin responses in the lower extremities were also reduced. Our findings indicate that the diagnostic utility of CSPs was higher than that of the autonomic tests to support the clinically suspected diagnosis of SFN. Muscle Nerve 43: 317-323, 2011Publication Metadata only Palmar cutaneous nerve conduction in patients with carpal tunnel syndrome(TAYLOR & FRANCIS LTD, 2015) İŞAK, BARIŞ; Uluc, Kayihan; Aktas, Ilknur; Sunter, Gulin; Koytak, Pinar Kahraman; Akyuz, Gulseren; Isak, Baris; Tanridag, Tulin; Us, OnderObjective: This study aimed to assess palmar cutaneous branch of the median nerve (PCBm) conduction in patients with clinically diagnosed carpal tunnel syndrome (CTS), to compare PCBm conduction with that of the median and ulnar nerves, and to determine the PCBm conduction abnormality rate in patients with CTS. Materials and Methods: The study included 99 hands of 60 patients with clinical CTS and 38 hands of 38 healthy controls. Sensory nerve conduction study (NCS) was performed on the median nerve, ulnar nerve, and PCBm, and onset latency, conduction velocity and amplitude were recorded. Additionally, differences in latency and velocity between the median nerve and PCBm, and the difference in latency between the median and ulnar nerves were calculated. Results: In all, 56% of the patients with CTS had abnormal PCBm conduction. Additionally, in 7 of 8 hands with abnormal sensation -both in the thenar eminence and abnormal sensory distribution along the main branch -NCS of the PCBm was also abnormal. Conclusions: The PCBm is not ideal as a comparator nerve for the neurophysiological diagnosis of CTS. The frequency of PCBm abnormality in CTS patients may be related to the concomitant damage in both of these nerves. Additionally, the present findings may help explain, at least in part, why patients with CTS often exhibit sensory involvement beyond the classical median nerve sensory borders.