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The M1 trusted 200mg quetiapine, then, activates and assemblies manage the coordination of multi- inactivates muscles in a precise spatial and tem- joint actions, the velocity and direction of poral pattern, including the controllers for frac- movements, and process the order of stimuli tionated finger movements. Using some clever on which a motor response will be elicited to hand posture tasks to dissociate muscle activ- carry out a task. Longer trains lasting 500 ms, which includes humans, with good manipula- which approximates the time scale of neuronal tive skills. Indeed, out of over 300 stimulation sites, coactivation of assemblies of neurons acting in 85% evoked a distinct posture. The map from parallel, not to the rate of firing of single neu- cortex to muscles also depends on arm position rons. For ex- the burst frequency codes movement velocity ample, when the elbow started in flexion, stim- and the burst duration codes the duration of ulation at one site caused it to extend to its fi- the movement. The force exerted elbow flexed to place the hand at the same po- by muscles is a summed average of the ouput sition. Spontaneous movements of the hand to of single cells that fire at variable rates and the the mouth followed the same pattern of mo- synchronization of assemblies of M1 neurons tion and EMG activity as stimulation-evoked during specific phases of a motor task. Thus, within the larger arm and gle cell activity in the motor cortex is most in- hand representation, stimulation-evoked pos- tense for reaching at a particular magnitude tures were organized across the cortex as a map and direction of force. All the evoked postures suggested typ- sembly of cells becomes active, the discharge ical behaviors such as feeding, a defensive pattern of a neuron within that population may movement, reaching, flinching, and others. As the active population Evoked postures were also found for the leg, evolves to include cells that had not previously in which stimulation elicited movements that participated or to exclude some of the cells that converged the foot from different starting had been active, the assembly becomes a positions to a single final location within its unique representation of different information ordinary workspace, much like what has about movement. The M1 Functional imaging studies reveal a small ac- computes the location of a target, the hand tra- tivation in ipsilateral motor cortex during sim- jectory, joint kinematics, and torques to reach ple finger tapping.

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J Bone Miner Res 7:1399–1406 Prince R effective quetiapine 200 mg, Gaich, GA, Reginster YI, JM, Ockene J, Writing Group for the 26. JAMA cyclical etidronate treatment of post- 1444 288:321–333 menopausal osteoporosis. Saag KG, Emkey R, Schnitzer TJ, Med 323:73–329 Brown JP, Hawkins F, Goemaere F, Thamsborg G, Lieberman UA, Delmas PD, Malice M-P, Czachur M, Daifotis AG (1998) Alendronate for the preven- tion and treatment of glucocorticoid-in- duced osteoporosis. Schenk R, Merz WA, Mühlbauer R, Russell RGG, Fleisch H (1973) Effect of ethane-1-hydroxy-1:1-diphospho- nate (EHDP) and dichloromethylene diphosphonate (Cl2MDP) on the calci- fication and resorption of cartilage and bone in the tibial epiphysis and meta- physis of rats. The approach to osteoporosis can favor- load necessary to cause a vertebral ably alter the disease. Lin · structure, mineral content, and qual- Osteoporosis · Bisphosphonates · M. Radiographic techniques PTH (1–34) · Falls Metabolic Bone Disease Service, centered on dual X-ray absorptiome- Hospital for Special Surgery, try (DXA) permit a determination of New York, New York, USA bone mass and fracture risk. Lane bisphosphonate and pulsatile PTH Department of Orthopaedic Surgery, profoundly decrease the risk of frac- Hospital for Special Surgery, 535 East 70th Street, ture (50+%). Fall prevention strate- NY 10021 New York, USA gies can further decrease the possi- have been developed that may decrease the fragility frac- Introduction ture rate by up to 50% compared with controls treated only with calcium [7, 24, 40, 70, 79]. During the same time pe- Osteoporosis is a serious problem in the United States, af- riod, two minimally invasive procedures have been devel- fecting as many as 13–18% of women and 3–6% of men oped to rapidly address painful vertebral fractures – verte- [49, 55, 64, 68, 89]. Details regarding these proce- than half of all Caucasian white women will sustain an os- dures are the subject of separate articles within this issue. Approx- imately one-half of these fractures are related to the verte- bral bodies, with two-thirds being silent and one-third Fracture etiology: factor of risk symptomatic.

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