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PET Scan Predicts Whether Drugs, Therapy Will Best Treat Depression

By MedImaging International staff writers
Posted on 27 Aug 2013

A recent pretreatment imaging scanning study of brain activity has forecasted whether depressed patients would best achieve remission with an antidepressant medication or psychotherapy.

If a patient’s pretreatment resting brain activity was low in the front part of the insula, on the right side of the brain (red area where green lines converge), it signaled a significantly higher probability of remission with cognitive behavior therapy (CBT) and a poor response to escitalopram, a serotonin-specific reuptake inhibitor (SSRI) antidepressant. Conversely, hyperactivity in the insula predicted remission with escitalopram and a poor response to CBT.

“Our goal is to develop reliable biomarkers that match an individual patient to the treatment option most likely to be successful, while also avoiding those that will be ineffective,” explained Helen Mayberg, MD, External Web Site Policy, of Emory University (Atlanta, GA, USA), a grantee of the US National Institutes of Health’s (NIH) National Institute of Mental Health (Bethesda, MD, USA).

Dr. Mayberg and colleagues reported their findings June 12, 2013, in JAMA Psychiatry. “For the treatment of mental disorders, brain imaging is still primarily a research tool, yet these results demonstrate how it may be on the cusp of aiding in clinical decision-making,” said NIMH director Thomas R. Insel, MD.

Currently, determining whether a specific patient with depression would best respond to psychotherapy or drug is based on trial and error. In the absence of any objective guidance that could predict improvement, clinicians typically try a treatment that they, or the patient, prefer for one month or two to see if it works. Therefore, only approximately 40% of patients achieve remission following initial treatment. This is expensive in terms of human suffering as well as healthcare spending.

Dr. Mayberg’s team hoped to identify a biomarker that could predict which type of treatment a patient would benefit from based on the state of his or her brain. Using a positron emission tomography (PET) scanner, they imaged pretreatment resting brain activity in 63 depressed patients. PET targets what areas of the brain are active at any given moment by tracing the destinations of a radioactively tagged form of glucose, the sugar that fuels its metabolism. They compared brain circuit activity of patients who achieved remission following treatment with those who did not improve.

Activity in one specific brain area was seen as a pivotal predictor of outcomes from two standard forms of depression treatment: CBT or escitalopram. If a patient’s pretreatment resting brain activity was low in the front part of an area called the insula, on the right side of the brain, it signaled a substantially higher likelihood of remission with CBT and a poor response to escitalopram. Conversely, hyperactivity in the insula predicted remission with escitalopram and a poor response to CBT.

Among several areas of brain activity related to outcome, activity in the anterior insula best predicted response and non-response to both treatments. The anterior insula is known to be important in regulating emotional states, self-awareness, decision-making, and other mental tasks. Alterations in insula activity have been seen in studies of a range of depression therapies, including medication, vagal nerve stimulation, and deep brain stimulation.

Emory clinical neuroscientists have examined brain scans in effort to find better ways to help patients recover from depression. “If these findings are confirmed in follow-up replication studies, scans of anterior insula activity could become clinically useful to guide more effective initial treatment decisions, offering a first step towards personalized medicine measures in the treatment of major depression,” concluded Dr. Mayberg.

Related Links:
Emory University
National Institute of Mental Health

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63 (395.05958557129): 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 (77.009201049805): select jos_twitters.link from jos_twitters where cat=10

65 (33.855438232422): select jos_facebook.link from jos_facebook where cat=10

66 (39.100646972656): select jos_google_plus.link from jos_google_plus where cat=10

67 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

68 (69.141387939453): SELECT fid FROM jos_deeppockets WHERE id=294747944 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294747944 AND published='1' LIMIT 1

69 (51.021575927734): 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 (395.05958557129): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (364.06517028809): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (58.889389038086): 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 (64.849853515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (35.04753112793): 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 (76.055526733398): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (65.088272094727): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (37.908554077148): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.961669921875): 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 (68.902969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

105 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

106 (69.141387939453): 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=294747944 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (64.13459777832): 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=294747944 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

109 (68.187713623047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

110 (52.928924560547): 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=294747944 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (606.06002807617): 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=294747944 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (737.19024658203): 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 (605.82160949707): 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 (189.06593322754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

115 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

116 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

117 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

118 (154.01840209961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

119 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

120 (339.98489379883): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 23573.160171509): 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

122 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

123 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

124 (412.94097900391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294747944 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294747944 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 528496.98066711): ( 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 (122.0703125): ( 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 (74.148178100586): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (47.922134399414): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (77.962875366211): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (66.041946411133): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (661.13471984863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (497.10273742676): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (359.77363586426): SELECT name FROM jos_deeppockets WHERE id=213

136 (46.014785766602): SELECT name FROM jos_deeppockets WHERE id=213

137 (588.89389038086): 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

138 (584.12551879883): 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

139 (155.92575073242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

140 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

141 (!!!!! 10550.975799561): TRUNCATE TABLE jos_trademed_module

142 (111.10305786133): 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=294747944 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (77.962875366211): 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=294747944 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (576.97296142578): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

147 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

148 (!!!!! 1411.9148254395): 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

149 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

150 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

151 (51.975250244141): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294747944 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294747944 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (45.061111450195): 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)

153 (40.054321289062): 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)

154 (42.200088500977): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

156 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294747944 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294747944 AND published='1' LIMIT 1

157 (39.815902709961): select jos_twitters.link from jos_twitters where cat=10

158 (35.04753112793): select jos_facebook.link from jos_facebook where cat=10

159 (37.193298339844): select jos_google_plus.link from jos_google_plus where cat=10

160 (34.809112548828): select jos_linkedin.link from jos_linkedin where cat=10

161 (327.82554626465): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1742.1245574951): insert into jos_banners_delta values (14615,'2025-06-19 21:04:49','216.73.216.120','view'),(14202,'2025-06-19 21:04:49','216.73.216.120','view'),(14203,'2025-06-19 21:04:49','216.73.216.120','view')

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