Michael Cerullo - Profile on Academia.edu (original) (raw)

Papers by Michael Cerullo

Universal Journal of Psychology, 2016

In severe depression thoughts of suicide can develop over weeks or months. Traditional pharmacolo... more In severe depression thoughts of suicide can develop over weeks or months. Traditional pharmacologic or psychotherapeutic treatments take several weeks before they begin to improve symptoms. This gradual improvement is consistent with our everyday experience of the self. However, a new treatment, ketamine, can alter depressive symptoms within hours or even minutes. Ketamine can stop suicidal thoughts in as little as 20 minutes and is being developed to treat suicidal patients in the emergency room. Rapid changes in a belief as complex as suicide raise new questions about the self and identity. More complicated models of the self are required to understand how rapid changes in complex beliefs are possible without invoking unrealistic specificity in the brain (i.e. grandmother cells for belief). If the brain has multiple competing selves within modules then ketamine could work by either turning a self module on or off. This is consistent with a modified version of the global workspace theory of consciousness where a self module provides the context for the spotlight of attention.

Journal of Ethics and Emerging Technologies, Mar 1, 2016

Chemical brain preservation allows the brain to be preserved for millennia. In the coming decades... more Chemical brain preservation allows the brain to be preserved for millennia. In the coming decades, the information in a chemically preserved brain may be able to be decoded and emulated in a computer. I first examine the history of brain preservation and recent advances that indicate this may soon be a real possibility. I then argue that chemical brain preservation should be viewed as a life-saving medical procedure. Any technology that significantly extends the human life span faces many potential criticisms. However, standard medical ethics entails that individuals should have the autonomy to choose chemical brain preservation. Only if the harm to society caused by brain preservation and future emulation greatly outweighed any potential benefit would it be ethically acceptable to refuse individuals this medical intervention. Since no such harm exists, it is ethical for individuals to choose chemical brain preservation.

Experiments on distant intercessory prayer. God, science, and the lesson of Massah. Chibnall JT,∗ ∗Department of Psychiatry, Saint Louis University School of Medicine, 1221 S Grand Blvd, St. Louis, MO 63104. E-mail: chibnajt@slu.eduJeral JM, Cerullo MA. Arch Intern Med 2001;161:2529 -2536

American Journal of Ophthalmology, 2002

Molecular Psychiatry, 2010

We examined sustained attention deficits in bipolar disorder and associated changes in brain acti... more We examined sustained attention deficits in bipolar disorder and associated changes in brain activation assessed by functional magnetic resonance imaging (fMRI). We hypothesized that relative to healthy participants, those with mania or mixed mania would (1) exhibit incremental decrements in sustained attention over time, (2) overactivate brain regions required for emotional processing and (3) progressively underactivate attentional regions of prefrontal cortex. Fifty participants with manic/mixed bipolar disorder (BP group) and 34 healthy comparison subjects (HC group) received an fMRI scan while performing a 15-min continuous performance task (CPT). The data were divided into three consecutive 5-min vigilance periods to analyze sustained attention. Composite brain activation maps indicated that both groups activated dorsal and ventral regions of an anterior-limbic network, but the BP group exhibited less activation over time relative to baseline. Consistent with hypotheses 1 and 2, the BP group showed a marginally greater behavioral CPT sustained attention decrement and more bilateral amygdala activation than the HC group, respectively. Instead of differential activation in prefrontal cortex over time, as predicted in hypothesis 3, the BP group progressively decreased activation in subcortical regions of striatum and thalamus relative to the HC group. These results suggest that regional activation decrements in dorsolateral prefrontal cortex accompany sustained attention decrements in both bipolar and healthy individuals. Stable amygdala overactivation across prolonged vigils may interfere with sustained attention and exacerbate attentional deficits in bipolar disorder. Differential striatal and thalamic deactivation in bipolar disorder is interpreted as a loss of amygdala (emotional brain) modulation by the ventrolateral prefrontal-subcortical circuit, which interferes with attentional maintenance.

Characterizing impulsivity in mania

Bipolar Disorders, 2009

To determine whether specific aspects of impulsivity (response disinhibition, inability to delay ... more To determine whether specific aspects of impulsivity (response disinhibition, inability to delay gratification, inattention) differ between healthy and bipolar manic subjects, and whether these aspects of impulsivity were associated with each other and severity of affective symptoms. Performance of 70 bipolar I manic or mixed patients was compared to that of 34 healthy subjects on three tasks specifically designed to study response inhibition, ability to delay gratification, and attention; namely, a stop signal task, a delayed reward task, and a continuous performance task, respectively. Correlations among tasks and with symptom ratings were also performed. Bipolar subjects demonstrated significant deficits on all three tasks as compared to healthy subjects. Performance on the three tasks was largely independent. Task performance was not significantly associated with the severity of affective symptom ratings. However, measures of response inhibition and attention were sensitive to medication effects. Differences in the delayed reward task were independent of medication effects or symptom ratings. During the delayed reward task, although bipolar patients made their choices more slowly than healthy subjects, they were significantly more likely to choose a smaller, but more quickly obtained reward. Moreover, performance on this task was not associated with performance on the other impulsivity measures. Manic patients showed more impulsive responding than mixed patients. Bipolar I manic patients demonstrate deficits on tests of various aspects of impulsivity as compared to healthy subjects. Some of these differences between groups may be mediated by medication effects. Findings suggested that inability to delay gratification (i.e., delayed reward task) was not simply a result of the speed of decision making or inattention, but rather that it reflected differences between bipolar and healthy subjects in the valuation of reward relative to delay.

Minds and Machines, 2014

If a brain is uploaded into a computer, will consciousness continue in digital form or will it en... more If a brain is uploaded into a computer, will consciousness continue in digital form or will it end forever when the brain is destroyed? Philosophers have long debated such dilemmas and classify them as questions about personal identity. There are currently three main theories of personal identity: biological, psychological, and closest continuer theories. None of these theories can successfully address the questions posed by the possibility of uploading. I will argue that uploading requires us to adopt a new theory of identity, psychological branching identity. Psychological branching identity states that consciousness will continue as long as there is continuity in psychological structure. What differentiates this from psychological identity is that it allows identity to continue in multiple selves. According to branching identity, continuity of consciousness will continue in both the original brain and the upload after nondestructive uploading. Branching identity can also resolve long standing questions about split-brain syndrome and can provide clear predictions about identity in even the most difficult cases imagined by philosophers.

Current Psychosis & Therapeutics Reports, 2006

Substance use disorders (SUDs) commonly co-occur during the course of bipolar type I disorder, an... more Substance use disorders (SUDs) commonly co-occur during the course of bipolar type I disorder, and they can negatively affect illness outcome. This paper reviews recent research examining SUDs in bipolar disorder. These studies confirmed the high prevalence rate of SUDs but found that they are less common in younger patients (< age 17 years). Two new longitudinal studies suggest that a co-occurring SUD worsens the prognosis of bipolar disorder and leads to more affective symptoms and suicide attempts. Two new studies have examined the treatment of bipolar patients with a comorbid SUD. These studies suggest that valproate (as an adjunct to lithium) and aripiprazole may be useful in the treatment of the affective symptoms of bipolar patients with a comorbid SUD and may also help with the treatment of the SUD.

Substance Abuse Treatment, Prevention, and Policy, 2007

The aim of this paper is to provide a systematic review of the literature examining the epidemiol... more The aim of this paper is to provide a systematic review of the literature examining the epidemiology, outcome, and treatment of patients with bipolar disorder and co-occurring substance use disorders (SUDs). Articles for this review were initially selected via a comprehensive Medline search and further studies were obtained from the references in these articles. Given the lack of research in this field, all relevant studies except case reports were included. Prior epidemiological research has consistently shown that substance use disorders (SUDs) are extremely common in bipolar I and II disorders. The lifetime prevalence of SUDs is at least 40% in bipolar I patients. Alcohol and cannabis are the substances most often abused, followed by cocaine and then opioids. Research has consistently shown that co-occurring SUDs are correlated with negative effects on illness outcome including more frequent and prolonged affective episodes, decreased compliance with treatment, a lower quality of life, and increased suicidal behavior. Recent research on the causal relationship between the two disorders suggests that a subgroup of bipolar patients may develop a relatively milder form of affective illness that is expressed only after extended exposure to alcohol abuse. There has been very little treatment research specifically targeting this population. Three open label medication trials provide limited evidence that quetiapine, aripiprazole, and lamotrigine may be effective in treating affective and substance use symptoms in bipolar patients with cocaine dependence and that aripiprazole may also be helpful in patients with alcohol use disorders. The two placebo controlled trials to date suggest that valproate given as an adjunct to lithium in bipolar patients with co-occurring alcohol dependence improves both mood and alcohol use symptoms and that lithium treatment in bipolar adolescents improves mood and SUD symptoms. Given the high rate of SUD co-occurrence, more research investigating treatments in this population is needed. Specifically, double blind placebo controlled trials are needed to establish the effectiveness of medications found to be efficacious in open label treatments. New research also needs to be conducted on medications found to treat either bipolar disorder or a SUD in isolation. In addition, it may be advisable to consider including patients with prior SUDs in clinical trials for new medications in bipolar disorder.

International Review of Psychiatry, 2009

Objectives-Functional neuroimaging methods have proliferated in recent years, such that functiona... more Objectives-Functional neuroimaging methods have proliferated in recent years, such that functional magnetic resonance imaging, in particular, is now widely used to study bipolar disorder. However, discrepant findings are common. A workgroup was organized by the Department of Psychiatry, University of Cincinnati (Cincinnati, OH, USA) to develop a consensus functional neuroanatomic model of bipolar I disorder based upon the participants' work as well as that of others. Methods-Representatives from several leading bipolar disorder neuroimaging groups were organized to present an overview of their areas of expertise as well as focused reviews of existing data. The workgroup then developed a consensus model of the functional neuroanatomy of bipolar disorder based upon these data. Results-Among the participants, a general consensus emerged that bipolar I disorder arises from abnormalities in the structure and function of key emotional control networks in the human

American Journal of Psychiatry, 2008

Perspectives in Biology and Medicine, 2006

The author would like to thank John Chibnall and Neil Scheurich for their helpful comments on ear... more The author would like to thank John Chibnall and Neil Scheurich for their helpful comments on earlier drafts of this manuscript.

Biological Psychiatry, 2011

Background-Bipolar I disorder is defined by the occurrence of mania. The presence of mania, coupl... more Background-Bipolar I disorder is defined by the occurrence of mania. The presence of mania, coupled with a course of illness characterized by waxing and waning of affective symptoms, suggests that bipolar disorder arises from dysfunction of neural systems that maintain emotional arousal and homeostasis. We used functional magnetic resonance imaging (fMRI) to study manic bipolar subjects as they performed a cognitive task designed to examine the ventrolateral prefrontal emotional arousal network. Methods-We used fMRI to study regional brain activation in 40 DSM-IV manic bipolar I patients and 36 healthy subjects while they performed a continuous performance task with emotional and neutral distracters. Event-related region-of-interest analyses were performed to test the primary hypothesis. Voxelwise analyses were also completed. Results-Compared with healthy subjects, the manic subjects exhibited blunted activation to emotional and neutral images, but not targets, across most of the predefined regions of interest. Several additional brain regions identified in the voxelwise analysis also exhibited similar differences between groups, including right parahippocampus, right lingual gyrus, and medial thalamus. In addition to these primary findings, the manic subjects also exhibited increased activation in response to targets in number of brain regions that were primarily associated with managing affective stimuli. Group differences did not appear to be secondary to medication exposure or other confounds.

PLOS Computational Biology, 2015

In the last decade, Guilio Tononi has developed the Integrated Information Theory (IIT) of consci... more In the last decade, Guilio Tononi has developed the Integrated Information Theory (IIT) of consciousness. IIT postulates that consciousness is equal to integrated information (F). The goal of this paper is to show that IIT fails in its stated goal of quantifying consciousness. The paper will challenge the theoretical and empirical arguments in support of IIT. The main theoretical argument for the relevance of integrated information to consciousness is the principle of information exclusion. Yet, no justification is given to support this principle. Tononi claims there is significant empirical support for IIT, but this is called into question by the creation of a trivial theory of consciousness with equal explanatory power. After examining the theoretical and empirical evidence for IIT, arguments from philosophy of mind and epistemology will be examined. Since IIT is not a form of computational functionalism, it is vulnerable to fading/ dancing qualia arguments. Finally, the limitations of the phenomenological approach to studying consciousness are examined, and it will be shown that IIT is a theory of protoconsciousness rather than a theory of consciousness.

Measurement of Impulsivity in Adolescents with Bipolar Disorder Versus Adolescents with ADHD

Journal of clinical and experimental neuropsychology, Jan 10, 2015

Previous research has shown that performance on cognitive tasks administered in the scanner can b... more Previous research has shown that performance on cognitive tasks administered in the scanner can be altered by the scanner environment. There are no previous studies that have investigated the impact of scanner noise using a well-validated measure of affective change. The goal of this study was to determine whether performance on an affective attentional task or emotional response to the task would change in the presence of distracting acoustic noise, such as that encountered in a magnetic resonance imaging (MRI) environment. Thirty-four young adults with no self-reported history of neurologic disorder or mental illness completed three blocks of the affective Posner task outside of the scanner. The task was meant to induce frustration through monetary contingencies and rigged feedback. Participants completed a Self-Assessment Manikin at the end of each block to rate their mood, arousal level, and sense of dominance. During the task, half of the participants heard noise (recorded from...

Topics in magnetic resonance imaging : TMRI, 2008

Although advances in the clinical criteria of various axis I psychiatric disorders are continuall... more Although advances in the clinical criteria of various axis I psychiatric disorders are continually being made, there is still considerable overlap in the clinical features, and diagnosis is often challenging. As a result, there has been substantial interest in using morphometric magnetic resonance imaging to better characterize these diseases and inform diagnosis. Region of interest and voxel-based morphometry studies are reviewed herein to examine the extent to which these goals are being met across various psychiatric disorders. It is concluded based on the studies reviewed that specific patterns of regional loss, although present in certain axis I disorders, are not, as yet, diagnostically useful. However, advances in outcome and treatment monitoring show considerably more promise for rapid application in psychiatry.

Expect psychiatric side effects from corticosteroid use in the elderly

Geriatrics, 2008

Psychiatric side effects including mania, depression, psychosis, and delirium, are extremely comm... more Psychiatric side effects including mania, depression, psychosis, and delirium, are extremely common in patients treated with corticosteroids. The elderly and those with previous psychiatric diagnoses are not at increased risk for these side effects, but females and those with prior corticosteroid-induced psychiatric side effects are. Depression and mania are the most frequent behavioral side effects, followed by psychosis and delirium. In the geriatric population, there is a long list of medical etiologies of psychosis, delirium, mania, and depression. These must be distinguished from corticosteroid side effects. Treatment involves stopping the corticosteroids, if possible, and targeting the specific psychiatric symptoms that develop.

Medical school exposure to spirituality and response to a hypothetical cancer patient

Journal of cancer education : the official journal of the American Association for Cancer Education, 2002

Spiritual and religious issues (SRI) in medical school curricula may promote psychosocial and spi... more Spiritual and religious issues (SRI) in medical school curricula may promote psychosocial and spiritual sensitivity, but few data exist on this relationship. A questionnaire was administered to third-year medical students (response rate = 69.2%). Students indicated exposure to SRI and read a vignette about a hypothetical cancer patient. SRI exposure through lectures, small-group discussions, and physician modeling predicted, respectively, likelihood of extra attention toward the patient, conversing with the patient about dying, and praying with the patient. Exposure to SRI in medical school may sensitize students to the psychosocial and spiritual needs of dying patients.

Journal of Affective Disorders, 2015

Background: Depressive and anxiety disorders are among the most frequently occurring psychiatric ... more Background: Depressive and anxiety disorders are among the most frequently occurring psychiatric conditions in children and adolescents and commonly present occur together. Co-occurring depression and anxiety is associated with increased functional impairment and suicidality compared to depression alone. Despite this, little is known regarding the neurostructural differences between anxiety disorders and major depressive disorder (MDD). Moreover, the neurophysiologic impact of the presence of anxiety in adolescents with MDD is unknown. Methods: Using voxel-based morphometry, gray matter volumes were compared among adolescents with MDD (and no co-morbid anxiety disorders, n ¼ 14), adolescents with MDD and co-morbid anxiety ("anxious depression," n ¼12), and healthy comparison subjects (n ¼41). Results: Patients with anxious depression exhibited decreased gray matter volumes in the dorsolateral prefrontal cortex (DLPFC) compared to patients with MDD alone. Compared to healthy subjects, adolescents with anxious depression had increased gray matter volumes in the pre-and post-central gyri. Limitations: The current sample size was small and precluded an analysis of multiple covariates which may influence GMV. Conclusions: Gray matter deficits in the DLPFC in youth with anxious depression compared to patients with MDD and no co-occurring anxiety may reflect the more severe psychopathology in these patients. Additionally, the distinct gray matter fingerprints of MDD and anxious depression (compared to healthy subjects) suggest differing neurophysiologic substrates for these conditions, though the etiology and longitudinal trajectory of the differences remain to be determined.

Bipolar Disorders, 2014

Objectives-Despite different treatments and course of illness, depressive symptoms appear similar... more Objectives-Despite different treatments and course of illness, depressive symptoms appear similar in major depressive disorder (MDD) and bipolar I disorder (BP-I). This similarity of depressive symptoms suggests significant overlap in brain pathways underlying neurovegetative, mood, and cognitive symptoms of depression. These shared brain regions might be expected to exhibit similar activation in individuals with MDD and BP-I during functional magnetic resonance imaging (fMRI). Methods-fMRI was used to compare regional brain activation in participants with BP-I (n = 25) and MDD (n = 25) during a depressive episode as well as 25 healthy comparison (HC) participants. During the scans, participants performed an attentional task that incorporated emotional pictures. Results-During the viewing of emotional images, subjects with BP-I showed decreased activation in the middle occipital gyrus, lingual gyrus, and middle temporal gyrus compared to both subjects with MDD and HC participants. During attentional processing, participants with MDD had increased activation in the parahippocampus, parietal lobe, and postcentral gyrus. However, among these regions, only the postcentral gyrus also showed differences between MDD and HC participants. Conclusions-No differences in cortico-limbic regions were found between participants with BP-I and MDD during depression. Instead, the major differences occurred in primary and secondary visual processing regions with decreased activation in these regions in BP-I compared