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Movement Disorders Imaging Scan Provides a Better Tool to Diagnose Parkinson’s Disease

By MedImaging International staff writers
Posted on 08 Sep 2011

Due to a new diagnostic imaging technique, physicians now have an objective test to assess patients for Parkinsonian syndromes. Up to now, there were no definitive tests to identify the disease, forcing physicians to rely on clinical examinations to make a diagnosis. This technology allows clinicians to distinguish Parkinson’s from other movement disorders.

Northwestern Memorial Hospital (Chicago, IL, USA) is among the first institutions in the country to offer DaTscan, the only US Food and Drug Administration (FDA)-approved imaging agent for assessment of movement disorders. “The scan by itself does not make the diagnosis of Parkinson’s but it allows us to identify patients who have loss of dopamine, the major chemical responsible for the symptoms, from those who have no dopamine deficiency,” said Tanya Simuni, MD, a neurologist at Northwestern Memorial and director of Northwestern’s Parkinson’s Disease and Movement Disorders Center. “This is a very important step in being able to accurately identify and treat movement disorders and hopefully allow us to better understand these diseases over time.”

People with Parkinson’s lack dopamine in the brain, which leads to tremor, slowness of movement, muscle stiffness, and balance problems. Clinical examinations, especially early in the disease when symptoms are slight, can be inconclusive or lead to misdiagnosis of another movement disorder, such as essential tremor, which has similar symptoms to Parkinson’s, but require different treatment.

Developed by GE Healthcare (Chalfont St. Giles, UK), DaTscan is a substance used to detect the presence of dopamine transporters (DaT) in the brain. A patient is injected with the contrast agent and then undergoes a single-photon emission computed tomography (SPECT) scan. The modality captures detailed pictures of the brain’s dopamine system and can provide visual evidence of the presence of dopamine transporters. Scans of patients with Parkinson’s disease or another Parkinsonian syndrome will show very low dopamine levels. A SPECT scan examines brain function, instead of structure, and can reveal change in the brain’s chemistry.

“In Parkinson’s patients the brain’s anatomy remains largely normal, unlike other conditions such as stroke, where damage to the brain is visible,” explained Dr. Simuni, who is also an associate professor of neurology at Northwestern University Feinberg School of Medicine (Chicago, IL, USA). “DaTscan attaches to dopamine neurons which illuminate on the SPECT scan; the more light areas that exist, the more healthy dopamine brain cells remain. If the areas of the brain that should show dopamine remain dark, it may indicate the patient has some type of Parkinsonian syndrome.”

An accurate clinical diagnosis for patients with neurodegenerative movement disorders, such as Parkinson's, can take up to six years. While symptoms frequently mimic Parkinson’s, other movement disorders, such as essential tremor, occur in different areas of the brain and do not involve the dopamine system.

“Even though they may appear similar, other movement disorders require different management. DaTscan allows us to confirm our diagnosis earlier and start the correct course of treatment sooner,” stated Dr. Simuni. “We are hopeful that this will lead to improved quality of life for these patients with better long term outcomes, as well as protection from unnecessary treatments initiated because of misdiagnosis.”

While Dr. Simuni does not believe it is essential for every patient to substantiate their Parkinson's diagnosis with DaTscan, she does see it as a valuable tool for patients with uncertain syndromes, or those who have not responded to treatment. She also sees it as a way of improving Parkinson’s research by ensuring those enrolled in studies actually have the disease. DaTscan is already being used by the Michael J. Fox Foundation for its landmark biomarkers study, the Parkinson’s Progression Markers Initiative (PPMI), to validate that the individuals have Parkinson’s disease. Northwestern is one of the 14 US medical centers enrolling for the PPMI, which is among the first clinical trials using DaTscan in this way.

“Currently, we are not able to say with certainty that those enrolled in Parkinson’s studies have the disease,” said Dr. Simuni. “With the addition of DaTscan, we can be much more confident in the status of research subjects in both the control and experimental groups. By having a better understanding of these populations, we should be able to have clearer outcomes and hopefully that will translate sooner into treatments and eventually a cure.”

Researchers are also hopeful that DaTscan will prove to be beneficial in following the progression of Parkinson’s throughout a patient’s lifetime. “The disease is clinically measured at certain points of time to help physicians understand its development,” added Dr. Simuni. “A lot of questions about how Parkinson’s disease progresses can be answered if DaTscan is able to show us changes in the brain's chemistry over time.”

Related Links:
Northwestern Memorial Hospital
GE Healthcare
Northwestern University Feinberg School of Medicine

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57 (!!!!! 9537.935256958): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

58 (!!!!! 1848.9360809326): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

59 (!!!!! 1435.9951019287): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

60 (518.0835723877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

61 (737.19024658203): 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 (514.03045654297): SELECT fid FROM jos_deeppockets WHERE id=294736990 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736990 AND published='1' LIMIT 1

63 (447.98851013184): 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=213 ORDER BY `ordering`

64 (975.8472442627): select jos_twitters.link from jos_twitters where cat=10

65 (53.167343139648): select jos_facebook.link from jos_facebook where cat=10

66 (41.007995605469): select jos_google_plus.link from jos_google_plus where cat=10

67 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

68 (40.054321289062): SELECT fid FROM jos_deeppockets WHERE id=294736990 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736990 AND published='1' LIMIT 1

69 (35.04753112793): 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=213 ORDER BY `ordering`

70 (277.04238891602): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (293.97010803223): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 2820.9686279297): 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 (!!!!! 2247.0951080322): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (102.04315185547): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (833.98818969727): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (92.983245849609): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (149.01161193848): 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 (!!!!! 1971.960067749): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (97.990036010742): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (72.002410888672): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (70.095062255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (274.8966217041): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3809.928894043): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

105 (123.97766113281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

106 (113.96408081055): 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=294736990 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (784.15870666504): 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=294736990 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 6405.8303833008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

109 (568.15147399902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

110 (126.12342834473): 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=294736990 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (917.19627380371): 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=294736990 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (823.974609375): 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 (550.0316619873): 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 (!!!!! 1336.0977172852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

115 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

116 (417.94776916504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

117 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

118 (508.06999206543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

119 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

120 (296.11587524414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

121 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

122 (406.98051452637): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 51748.037338257): 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 (!!!!! 6638.0500793457): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736990 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736990 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 18967.151641846): ( 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 (!!!!! 1247.8828430176): ( 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 (87.02278137207): 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 (34.809112548828): 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 (59.843063354492): 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 (42.915344238281): 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 (480.17501831055): 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 (48.160552978516): 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 (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

134 (30.994415283203): 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 (!!!!! 1214.0274047852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (379.08554077148): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (670.19462585449): SELECT name FROM jos_deeppockets WHERE id=213

138 (429.86869812012): SELECT name FROM jos_deeppockets WHERE id=213

139 (600.81481933594): 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 '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (555.99212646484): 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 '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (838.04130554199): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

142 (153.0647277832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

143 (!!!!! 8997.917175293): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 6571.0544586182): 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=294736990 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (703.09638977051): 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=294736990 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 4017.8298950195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 7741.9281005859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 7051.944732666): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

149 (677.10876464844): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

150 (!!!!! 15383.005142212): 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 (!!!!! 7719.9935913086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

152 (!!!!! 7950.0675201416): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

153 (!!!!! 5537.9867553711): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736990 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736990 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (422.95455932617): 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=213 or channel_id is null)

155 (!!!!! 3367.9008483887): 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=213 or channel_id is null)

156 (!!!!! 6030.0827026367): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 7726.9077301025): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

158 (!!!!! 8156.0611724854): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736990 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736990 AND published='1' LIMIT 1

159 (!!!!! 7425.06980896): select jos_twitters.link from jos_twitters where cat=10

160 (!!!!! 8130.0735473633): select jos_facebook.link from jos_facebook where cat=10

161 (!!!!! 8166.0747528076): select jos_google_plus.link from jos_google_plus where cat=10

162 (!!!!! 7569.7898864746): select jos_linkedin.link from jos_linkedin where cat=10

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