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Diffusion-Tensor MRI Shows Brain Abnormalities in Patients with Chronic Fatigue

By MedImaging International staff writers
Posted on 12 Nov 2014

Image: Example of an MR image of a control subject’s brain on top and a chronic fatigue brain on bottom. The ventricles are larger in the chronic fatigue syndrome patient, and there is less white matter. Abnormal microstructure is present on one side in the white matter in chronic fatigue syndrome (Photo courtesy of Michael Zeineh, Stanford University).

Radiology researchers have discovered that the brains of patients with chronic fatigue syndrome (CFS) have reduced white matter and white matter abnormalities in the right hemisphere of the brain. They used neuroimaging techniques to examine the brains of patients with chronic fatigue syndrome and healthy people, and found distinct differences between the two groups.

Investigators Dr. Michael Zeineh and his colleagues, from by Stanford University School of Medicine (CA, USA), has found clear differences between the brains of patients with chronic fatigue syndrome and those of healthy people.

The findings could lead to more conclusive diagnoses of the syndrome and may also indicate an underlying mechanism in the disease process. It is not unusual for CFS patients to face several mischaracterizations of their condition, or even suspicions of hypochondria, before receiving a diagnosis of CFS. The abnormalities identified in the study, published October 29, 2014, in the journal Radiology, may help to help solve those ambiguities, according to lead author Michael Zeineh, MD, PhD, assistant professor of radiology. “Using a trio of sophisticated imaging methodologies, we found that CFS patients’ brains diverge from those of healthy subjects in at least three distinct ways,” Dr. Zeineh said.

CFS affects between one million and four million individuals in the United States and millions more worldwide. While all CFS patients share a common symptom—constant fatigue that persists for six months or longer—the additional symptoms can differ from one patient to the next, and they frequently overlap with those of other conditions.

“CFS is one of the greatest scientific and medical challenges of our time,” said the study’s senior author, Jose Montoya, MD, professor of infectious diseases and geographic medicine. “Its symptoms often include not only overwhelming fatigue but also joint and muscle pain, incapacitating headaches, food intolerance, sore throat, enlargement of the lymph nodes, gastrointestinal problems, abnormal blood-pressure and heart-rate events, and hypersensitivity to light, noise, or other sensations.”

The combination of symptoms can devastate a patient’s life for 10, 20, or even 30 years, reported Dr. Montoya, who has been following 200 CFS patients for several years in an effort to identify the syndrome’s underlying mechanisms. He expects that this discovery will hasten the development of more-effective treatments than the currently available ones. “In addition to potentially providing the CFS-specific diagnostic biomarker we’ve been desperately seeking for decades, these findings hold the promise of identifying the area or areas of the brain where the disease has hijacked the central nervous system,” Dr. Montoya said.

“If you don’t understand the disease, you’re throwing darts blindfolded,” said Dr. Zeineh. “We asked ourselves whether brain imaging could turn up something concrete that differs between CFS patients’ and healthy people’s brains. And, interestingly, it did.”

The Stanford investigators compared brain images of 15 CFS patients chosen from the group Montoya has been following to those of 14 age- and sex-matched healthy volunteers with no history of fatigue or other conditions causing symptoms similar to those of CFS. The analysis generated three significant findings, according to the researchers. First, a magnetic resonance imaging (MRI) scan revealed that overall white-matter content of CFS patients’ brains, compared with that of healthy subjects’ brains, was lessened. Gray matter areas specialize in processing data, and the former in conveying the information from one part of the brain to another.

That finding was not completely unexpected, Dr. Zeineh reported. CFS is believed to involve chronic inflammation, possibly as a protracted immunologic response to an as-yet unspecified viral infection. Inflammation is known to inflict damage on white matter. However, a second finding was totally unexpected. Using an advanced MRI technique--diffusion-tensor imaging (DTI), which is particularly suited to evaluating the integrity of white matter--Dr. Zeineh and his colleagues identified a consistent abnormality in a particular part of a nerve tract in the right hemisphere of CFS patients’ brains. This tract, which connects two regions of the brain called the frontal lobe and temporal lobe, is called the right arcuate fasciculus, and in CFS patients it assumed an abnormal appearance.

Furthermore, there was a fairly strong correlation between the degree of abnormality in a CFS patient’s right arcuate fasciculus and the severity of the patient’s condition, as assessed by performance on a standard psychometric test used to evaluate fatigue.

Although the right arcuate fasciculus’s function is still somewhat elusive, its counterpart in the brain’s left hemisphere has been extensively studied. The left arcuate fasciculus connects two critical language areas of the left side of the brain termed Wernicke’s and Broca’s areas, which are gray-matter structures several centimeters apart. These two structures are important to understanding and generating speech, respectively. Right-handed individuals nearly always have language organized in this manner exclusively in the left side of the brain, but the precise side (left or right) and location of speech production and comprehension are not so clear-cut in left-handed people. Therefore, pooling left- and right-handed people’s brain images can be misleading. Furthermore, the finding of an abnormality in the right arcuate fasciculus, pronounced among right-handers, was unclear until the two left-handed patients and four left-handed control subjects’ images were exempted from the analysis. “This study was a start. It shows us where to look.”

Reinforcing these observations was the third finding: a thickening of the gray matter at the two areas of the brain connected by the right arcuate fasciculus in CFS patients, compared with controls. Its correspondence with the observed abnormality in the white matter joining them makes it unlikely that the two were chance findings, according to Dr. Zeineh. Although these results were quite robust, he said, they will need to be confirmed. “This study was a start,” he said. “It shows us where to look.”

The Stanford researchers are in the planning stages of a substantially larger study. The study was supported by GE Healthcare (Chalfont St. Giles, UK) and by the CFS Fund, which is housed in the Stanford.

Related Links:
Stanford University School of Medicine

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53 (325.91819763184): SELECT name FROM jos_deeppockets_archive WHERE id=294755672 LIMIT 1

54 (76.055526733398): 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 (87.976455688477): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

56 (895.97702026367): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

57 (!!!!! 1135.1108551025): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

58 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

59 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

60 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

61 (91.075897216797): 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 (447.03483581543): SELECT fid FROM jos_deeppockets WHERE id=294755672 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294755672 AND published='1' LIMIT 1

63 (276.08871459961): 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 (46.014785766602): select jos_twitters.link from jos_twitters where cat=10

65 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

66 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (29.802322387695): SELECT fid FROM jos_deeppockets WHERE id=294755672 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294755672 AND published='1' LIMIT 1

69 (36.001205444336): 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 (169.99244689941): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (135.89859008789): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (43.153762817383): 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 (89.883804321289): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (56.028366088867): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (32.901763916016): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (36.001205444336): 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 (69.856643676758): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (90.837478637695): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

105 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

106 (56.028366088867): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (47.922134399414): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

109 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

110 (57.220458984375): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (483.98971557617): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (575.06561279297): 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 (302.07633972168): 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 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

115 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

116 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

117 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

118 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

119 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

120 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

121 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

122 (185.01281738281): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 18975.973129272): 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 (445.12748718262): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755672 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755672 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7032.1559906006): ( 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 (75.101852416992): ( 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 (188.11225891113): 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 (45.061111450195): 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 (138.99803161621): 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 (67.949295043945): 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 (113.01040649414): 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 (33.855438232422): 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 (107.0499420166): 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 (36.001205444336): 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 (334.9781036377): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (257.01522827148): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (123.02398681641): SELECT name FROM jos_deeppockets WHERE id=212

138 (31.948089599609): SELECT name FROM jos_deeppockets WHERE id=212

139 (516.89147949219): 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 (452.99530029297): 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 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

142 (45.7763671875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

143 (!!!!! 7914.0663146973): TRUNCATE TABLE jos_trademed_module

144 (104.90417480469): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (57.93571472168): 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=294755672 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (863.07525634766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (52.213668823242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

149 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

150 (!!!!! 1271.0094451904): 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 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

152 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

153 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755672 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755672 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (29.087066650391): 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 (26.941299438477): 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 (49.829483032227): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (351.90582275391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

158 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755672 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755672 AND published='1' LIMIT 1

159 (147.10426330566): select jos_twitters.link from jos_twitters where cat=10

160 (37.908554077148): select jos_facebook.link from jos_facebook where cat=10

161 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

162 (36.954879760742): select jos_linkedin.link from jos_linkedin where cat=10

163 (283.95652770996): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (921.01097106934): insert into jos_banners_delta values (14615,'2025-06-23 16:11:32','216.73.216.120','view'),(14202,'2025-06-23 16:11:32','216.73.216.120','view'),(14203,'2025-06-23 16:11:32','216.73.216.120','view')

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