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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

fMR Brain Imaging Provides View into Consciousness

By MedImaging International staff writers
Posted on 10 Mar 2011

Employing an advanced imaging modality to probe for higher-level cognitive functioning in severely brain-injured patients provides a window into consciousness--but the view it presents is one that is blurred in enigmatic ways.

Researchers from Weill Cornell Medical College (New York, NY, USA) published their findings in the February 25, 2011, online edition of the journal Brain. In the unique study of six patients ranging in their function from minimally conscious state to the locked-in syndrome (normal cognitive function with severe motor impairment), the investigators looked at how the brains of these patients respond to a set of commands and questions while being scanned with functional magnetic resonance imaging (fMRI).

The investigators discovered there was a wide, and largely unpredictable, variation in the ability of patients to respond to a basic command (such as "imagine swimming--now stop”) and then using that same command to answer yes/no or multiple-choice questions. This variation was apparent when compared with their ability to interact at the bedside using voice or gesture.

Some patients unable to communicate by gestures or voice were unable to do the mental tests, while others unable to communicate by gestures or voice were intermittently able to answer the researchers' questions using mental imagery. Moreover, enigmatically, some patients with the ability to communicate through gestures or voice were unable to do the mental tasks.

The researchers reported that these findings suggest that no exam currently exists that can accurately assess the higher-level functioning that may be, and indeed seems to be, occurring in a number of severely brain-injured patients--but that progress is being made. "We have to abandon the idea that we can rely on a bedside exam in our assessment of some severe brain injuries. These results demonstrate that patients who show very limited responses at the bedside may have higher cognitive function revealed through fMRI,” stated the study's corresponding author, Dr. Nicholas D. Schiff, professor of neurology and neuroscience and professor of public health at Weill Cornell Medical College and a neurologist at New York-Presbyterian Hospital/Weill Cornell Medical Center.

Whereas progress has been made in determining the range of brain function in those who are severely injured, Dr. Schiff urged caution. "Although everyone wants to use a tool like this, fMRI is not yet capable of making clear measurements of cognitive performance. There will be a range of possible responses reflecting different capabilities in these patients that we have to further explore and understand.”

The new study evaluated three levels of communication in steps that required increasing cognitive capacity, noted Dr. Henning Voss, who is the study's senior investigator and associate professor of physics in radiology at Weill Cornell Medical College. "While we could not unambiguously establish communication in these brain-injured patients, our research is helping us identifying problems specific to this patient population,” Dr. Voss stated. "We got a clear picture about where and how to look for this kind of brain activity in response to certain commands.”

"Thousands of people suffer debilitating brain injuries every year, and there is a clear ethical imperative to learn as much as possible about their ability to communicate,” said the study's lead author, Jonathan Bardin, a third-year neuroscience graduate student at Weill Cornell Medical College. "These findings caution us against giving too much weight to negative results and open our eyes to the diversity of responses one might expect from the wide-ranging group of severely brain-injured people,” he remarked.

The potential implications of these kinds of consciousness studies are significant, according to coauthor Dr. Joseph Fins, a professor of medical ethics, chief of the division of medical ethics, and professor of medicine, professor of public health, and professor of medicine in psychiatry at Weill Cornell Medical College. "Beyond facilitating communication with these patients, these studies should communicate to society at large this population is worthy of our collective attention. A vast majority of severely brain-injured patients around the country are receiving substandard care because they are improperly diagnosed, not given adequate rehabilitation, and often end up in nursing homes. We all want this to change.” Dr. Fins is also director of medical ethics and chairman of the ethics committee at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

The Weill Cornell study is a continuation of research into how fMRI can establish a line of communication with brain-injured patients in order to understand if they can benefit from rehabilitation, and to assess their level of pain and other clinical parameters that would improve care and quality of life.

Research collaborators in Cambridge, UK, and Liege, Belgium, published earlier demonstrations in 2006 and 2010 that severely brain-injured patients could respond to commands or questions. The present studies extend the earlier findings and represent an important confirmation of such measurements by independent scientists.

In the current study, the dissociations observed and the wide range of communication capacities in the patient subjects studied provide unique insights. In the first step, the 6 patients, as well as 14 control participants, were asked a command that formed the basis for further communication. The control volunteers were asked to imagine performing their favorite sports, the patients, to imagine themselves swimming. Then, in the three patients who could do this, and in all of the controls, the researchers asked them to use the same imagined activity to respond to one or two options in a simple two-part question. In the third multiple-choice task, they were shown a face card from a deck of playing cards, then asked to respond when either the face or suit of the card was named.

The scans revealed a number of "dissociations” in these patients--"surprising instances in which patients” imaging responses diverged from their behavior,” Mr. Bardin said. One patient could generate the mental imagery but not use it to answer questions--although he could communicate accurately with gestures. Another patient, who can speak, could not carry out the mental imagery task. A third patient who could imagine swimming on command showed dramatically varied brain response patterns when tested over time.

"The patients participating in this study often have multiple or widespread brain injuries affecting not only local brain areas but the whole brain network on a wide scale,” Dr. Voss remarked. "Even if we knew precisely all the injuries involved in a subject, our still-limited understanding of the brain networks involved in communication makes it impossible to accurately predict remaining cognitive and communicative skills in many cases. If there is no normal communication possible, fMRI can reveal cognitive capacities on several levels.”

"This is a reality check, in essence, because there is a wide range of cognitive abilities in these patients, and the implications on the extreme ends of the spectrum are important,” Dr. Schiff said. "There are people whose personal autonomy is abridged because they don't have a good motor channel to express themselves despite their clear mind and opinions and desires about themselves and the world. And there are people who are without cognitive capacity, but because there is a misinterpretation of what is possible, there is a willingness to hold out hope. Not all minimally conscious patients are the same, and not all patients with locked-in syndrome are the same.”

The researchers, along with others in the field, is planning a major multicenter trial of fMRI along with European and Canadian colleagues to better determine both its potential and limitation in assessing cognitive abilities in severely brain-injured patients.

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49 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

50 (241.99485778809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

51 (89.168548583984): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

52 (602.96058654785): SELECT name FROM jos_deeppockets WHERE id=294733800 LIMIT 1

53 (476.12190246582): SELECT name FROM jos_deeppockets_archive WHERE id=294733800 LIMIT 1

54 (69.141387939453): SELECT a.* FROM jos_components AS a WHERE ( a.admin_menu_link = 'option=com_syndicate' OR a.admin_menu_link = 'option=com_syndicate&hidemainmenu=1' ) AND a.option = 'com_syndicate'

55 (110.14938354492): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

56 (681.16188049316): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 1806.9744110107): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

58 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

59 (165.93933105469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

60 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

61 (!!!!! 1092.9107666016): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (!!!!! 1446.9623565674): SELECT fid FROM jos_deeppockets WHERE id=294733800 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294733800 AND published='1' LIMIT 1

63 (961.0652923584): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (!!!!! 1046.895980835): select jos_twitters.link from jos_twitters where cat=10

65 (645.16067504883): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 1111.0305786133): select jos_google_plus.link from jos_google_plus where cat=10

67 (592.94700622559): select jos_linkedin.link from jos_linkedin where cat=10

68 (762.939453125): SELECT fid FROM jos_deeppockets WHERE id=294733800 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294733800 AND published='1' LIMIT 1

69 (520.94459533691): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (!!!!! 3592.9679870605): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (639.20021057129): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (72.956085205078): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (295.16220092773): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (!!!!! 3376.9607543945): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (!!!!! 1960.0391387939): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 2013.9217376709): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (85.115432739258): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (96.797943115234): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (!!!!! 2212.0475769043): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (758.88633728027): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (216.96090698242): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (60.081481933594): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (64.849853515625): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (51.975250244141): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (118.01719665527): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (305.8910369873): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (75.101852416992): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (132.79914855957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

105 (404.83474731445): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

106 (97.036361694336): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (133.03756713867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (166.89300537109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

109 (!!!!! 1271.0094451904): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

110 (181.19812011719): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (746.01173400879): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (985.14556884766): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (724.07722473145): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

115 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

116 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

117 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

118 (104.18891906738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

119 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

120 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

121 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

122 (995.87440490723): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 119392.15660095): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 4179.0008544922): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733800 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733800 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 66902.160644531): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 4017.8298950195): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 5280.9715270996): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (!!!!! 1529.9320220947): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (!!!!! 2529.8595428467): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (95.844268798828): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (311.13624572754): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (102.99682617188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (236.03439331055): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (89.883804321289): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (463.96255493164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (401.97372436523): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (181.91337585449): SELECT name FROM jos_deeppockets WHERE id=212

138 (68.902969360352): SELECT name FROM jos_deeppockets WHERE id=212

139 (893.11599731445): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (844.95544433594): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (174.99923706055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

142 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

143 (!!!!! 8721.1132049561): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 1907.8254699707): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (162.12463378906): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733800 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (464.91622924805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (211.95411682129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

149 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

150 (!!!!! 1752.1381378174): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (121.8318939209): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

152 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

153 (54.121017456055): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733800 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733800 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (38.862228393555): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (36.001205444336): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (43.153762817383): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (190.01960754395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

158 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733800 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733800 AND published='1' LIMIT 1

159 (199.79476928711): select jos_twitters.link from jos_twitters where cat=10

160 (46.014785766602): select jos_facebook.link from jos_facebook where cat=10

161 (40.054321289062): select jos_google_plus.link from jos_google_plus where cat=10

162 (41.007995605469): select jos_linkedin.link from jos_linkedin where cat=10

163 (462.05520629883): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1473.9036560059): insert into jos_banners_delta values (14615,'2025-06-27 12:05:07','216.73.216.249','view'),(14202,'2025-06-27 12:05:07','216.73.216.249','view'),(14203,'2025-06-27 12:05:07','216.73.216.249','view')

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