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 Evaluation of peripheral and autonomic neuropathy among patients with newly diagnosed impaired glucose tolerance(WILEY, 2008) İŞAK, BARIŞ; Isak, Baris; Oflazoglu, Buket; Tanridag, Tulin; Yitmen, Irem; Us, OnderBackground We have aimed to investigate the presence of peripheral and autonomic neuropathy in individuals who had been diagnosed with impaired glucose tolerance (IGT) on the basis of an oral glucose tolerance test, by comparing with age-matched healthy subjects with an oral glucose tolerance test (OGTT) in normoglycernic ranges. Material and methods Conventional nerve conduction studies, heart rate variation variability, heart rate response to deep breathing, heart rate response blood pressure response to standing up quickly, hand to valsalva maneuvre, grip test and sympathetic skin response tests were used to evaluate the IGT and the control subjects. Results No obvious statistical difference indicating peripheral neuropathy and/or cardiac autonomic neuropathy was detected between patient group and controls. Amplitudes of sympathetic skin response of two limbs (right upper and lower extremities) were lower in the IGT patient group when compared to healthy controls (p < 0.05) indicating the presence of sudomotor autonomic neuropathy. Conclusion Complaints and neurological examinations of patients with IGT were thought to be consistent with small-fiber neuropathy in the early phase of glucose intolerance. Not detecting any neuropathic findings in conventional electroneurography should be attributed to insufficient time allowed for settling down of large-fiber neuropathy. Obtaining no response in some of the patients in addition to general decrease in the amplitudes of sympathetic skin responses indicates that sudomotor fibers tend to be affected earlier in autonomic neuropathy in the group with IGT when compared with healthy controls. Newly diagnosed IGT patients take receive priority in primary protection since the time for settling down of cardiac autonomic neuropathy was short. Copyright (c) 2008 John Wiley & Sons, Ltd.Publication Metadata only Use of CMAP, MScan fit-MUNE, and MUNIX in understanding neurodegeneration pattern of ALS and detection of early motor neuron loss in daily practice(ELSEVIER IRELAND LTD, 2021) İŞAK, BARIŞ; Gunes, Taskin; Sirin, Nermin Gorkem; Sahin, Sevki; Kose, Ercan; Isak, BarisBackground: The pattern of lower motor neuron (LMN) degeneration in amyotrophic lateral sclerosis (ALS), i.e., dying-back (from the nerve ending to cell body) or dying-forward (from the cell body to nerve ending), has been widely discussed. In this study, we aimed to evaluate LMN loss using compound muscle action potential (CMAP), motor unit number index (MUNIX), and MScan-fit-based motor unit number estimation (MUNE) to understand the pattern of neurodegeneration in ALS. Methods: Twenty-five patients were compared with 25 controls using CMAP amplitude and area, MUNIX, and MScan-fit MUNE in three proximal and distal muscles innervated by the ulnar nerve. Results: Unlike the controls, the CMAP area, MScan-fit MUNE, and MUNIX recorded in ALS patients showed more neurodegeneration in distal muscles than proximal muscles. In ALS patients with unaffected CMAP amplitudes (n = 13), the CMAP area, MScan-fit MUNE, and MUNIX showed subtle motor unit loss of 30.7 %, 53.8 %, and 38.4 %, respectively. Conclusion: The CMAP area, MScan-fit MUNE, and MUNIX showed neurodegeneration earlier than the reduction in CMAP amplitude. These tests confirmed dying-back neurodegeneration, while only MUSIX showed re-innervation in ALS.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 Bilir kişi raporu(2020-09-01) MİDİ, İPEK; AKVARDAR, YILDIZ; İNANICI, MEHMET AKİF; İŞAK, BARIŞ; MİDİ İ., AKVARDAR Y., TOPÇUOĞLU V., İNANICI M. A., İŞAK B.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 Stereological and electrophysiological evaluation of autonomic involvement in amyotrophic lateral sclerosis(2022-11-01) AKDENİZ, ESRA; İŞAK, BARIŞ; Ozturk R., Karlsson P., Hu X., AKDENİZ E., Surucu S., İŞAK B.© 2022 Elsevier Masson SASObjective: Previous studies have identified autonomic dysfunction in amyotrophic lateral sclerosis (ALS) using mostly neurophysiological techniques. In this study, stereological evaluation of autonomic fibers and sweat glands has been performed to identify structural evidence of autonomic denervation in patients with ALS. Methods: In this study, 29 ALS patients were compared to 29 controls using COMPASS-31 questionnaire, sympathetic skin response (SSR), and heart rate variability (HRV) at rest. From the same cohorts, 20 ALS patients and 15 controls were further evaluated using staining of autonomic nerve fibers and sweat glands in skin biopsies. SSR and resting HRV were repeated in the ALS patient cohort one year later. Results: COMPASS-31 total score, gastrointestinal- and urinary-sub scores were higher in ALS patients than controls (P = 0.004, P = 0.005, and P = 0.049, respectively). In the ALS patient cohort, SSR amplitudes in hands and feet were lower than in controls (P0.05). While there was no change in nerve fibers innervating sweat glands, their density was lower in ALS patients than controls, and semi-quantitative analysis also showed structural damage (P = 0.02 and P = 0.001, respectively). SSR and resting HRV of ALS patients remained stable during the one-year follow-up period (P>0.05). Discussion: Supporting abnormal neurophysiological tests, stereological analysis revealed direct evidence of autonomic denervation in ALS patients. However, the degenerative process in autonomic nerve fibers is relatively slow, compared to the rate of motor neuron degeneration in this condition.