The electrical excitability of the dendrites of the cortical neurons was first studied on the apical dendrites of the pyramidal neurons. Professor ZHANG Xiang-Tong (H-T Chang) made important contributions in the fifties of last century on this topic. Through numerous studies later on, it has been established that the electrical excitability of dendrites of different types of neurons, even different dendrites in the same neuron is different. For the apical dendrites of the cortical pyramidal neurons, neither a single nor a train of repetitive action potentials with constant frequency can reach its terminal portion. However, some of the burst repetitive responses with non-constant frequency of the apical dendrite elicited by direct current injected into the soma may reach the terminal portion. This may be due to: (1) the calcium ion concentration in the apical dendrite is increased by the burst activities, which, in turn, increases the electrical excitability of the apical dendrite and /or (2) some retrograde collaterals of axon of the activated soma reach the apical dendrite and release neurotransmitter glutamate, which changes the properties of the voltage-gated ion channels in the apical dendrite. Low electrical excitability of the apical dendrites seems to be essential for the processing of numerous income signals to the terminal portion of the apical dendrites.
Action Potentials ; Animals ; Dendrites ; physiology ; Electrophysiological Phenomena ; Ion Channels ; physiology ; Pyramidal Cells ; physiology ; Synaptic Transmission

Objectives: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition.The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach. Methods: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and anti resorptive agents in sequential therapy approaches. Results: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to anti resorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for in dividuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment. Conclusions This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.