Craniopagus Conjoined TwinsTheir Cognition and Separate Personality TypesBy: Kelsey Simon

QuestionHow is it that craniopagus conjoined twins can have a connected brain but their cognition can be completely separate from the other twin and in all cases, have different personalities?

HypothesisOr Maybe NotI didnt really have a hypothesis of what I thought the reason pertained to. I really had nothing to form my idea around because I really knew nothing about craniopagus conjoined twins. The only thing I expected was that the craniopagus conjoined twins level of cognition had to do with the brain (nature) and not nurture.

The Search For this topic, I was looking for individual cases of craniopagus conjoined twins that would give me a description of the physical makeup of the conjoined brain and the joint abilities as a result of the conjoined brain. I do not think that I realized that all craniopagus conjoined twins have different amounts of their brains connected. This made the topic even more interesting to me because then I got to research the abilities of conjoined twins that non-conjoined people can not experience.

In this presentation we will look at three sets of conjoined twins.1. Trishna and Krishna 2. Tatiana and Krista 3. George and Lori We will compare and contrast these sets of twins focusing on the different physical structures of their brains and the different abilities that come along with that. We will also note the different personalities that arise in these twins.

Terms You Need To Know Craniopagus conjoined twins- conjoined twins that are fused at the cranium; do not always have to share brain surface but most doThalamus- the sensory processing center of the brain

1.)Trishna and Krishna: Major Findings

Trishna and Krishna: Background Info Trishna and Krishna were left by their mother at a Bangladeshi orphanage. Trishna was very ill from heart failure and both the girls were expected to die within 6 months. The Children First Foundation brought Trishna and Krishna to Royal Childrens Hospital in Australia for their separation surgery. Moira Kelley, who is head of the Children First Foundation now calls herself their mother.

Trishna and Krishna: Twins Successfully SeparatedTrishna and Krishna were separated November 16 and 17 of 2009. Separating conjoined twins especially craniopagus conjoined twins is one of the most dangerous surgeries that can be performed, so the fact that these two little girls survived is a miracle in itself. Doctors estimated that the girls had a 25% chance of coming out of the surgery successfully. It took 31.5 hours to separate the twins.

Trishna and Krishna: Life After Separation Trishna recovered into a normal healthy child but Krishna has had ongoing problems with her heart, blood pressure, and kidneys. They are overall living healthy with their caretaker Moria Kelley.

Trishna and Krishna: How Brain Was ConnectedTrishna and Krishnas brain had almost no shared surface area. Mainly the only shared part of the brain was interconnected blood vessels that created blood flow between the two brains. Severing the blood vessels was the only part of the procedure that was somewhat problematic. When the doctors first started to reduce blood flow, Trishnas blood pressure rose while Krishnas went down. As the became

Trishna and Krishna: How Brain Was Connected Cont. more separated, they recovered and seemed to be doing even better than when they had been fully connected.

What Conclusions/Questions Can We Draw From Trishnas And Krishnas Separation? From the separation of Trishna and Krishna, we know that craniopagus twins can be separated, but to what extent? Trishna and Krishna only shared blood vessels but what if they had shared parts of the brain? Could they have separated them then?We will find out from our next two set of twins that not all craniopagus twins can be separated.

2.)Tatiana and Krista Hogan: Major Findings

Tatiana and Krista Hogan: Background InfoTatiana and Krista Hogan were born on October 25, 2006 in Vernon, British Columbia, Canada. At age two, the girls still could not walk and could hardly talk.

Tatiana and Krista Hogan: Connection Of The Nervous System Tatiana and Krista Hogan have a neural bridge that connects one girls thalamus to the others. The thalamus is the sensory processing station of the brain. All sensory impute goes through the thalamus before it goes to the cortex. This connection allows one twin to receive the sensory impute that the other twin experiences.

Tatiana and Krista Hogan: Examples Of Shared Sensory Experiences You can put a stuffed animal in front of Tatiana and cover Kristas eyes, yet Krista can still tell you what stuffed animal it is. Both twins have this ability. If you touch one twin, the other twin can tell you were you have touched the first twin. If you tickle one twin, the other will giggle in response as if you had tickled her. When one twin is receiving sensory impute the other ones eyes will be directed straight forward with this glazed over look; their pupils will then move back and forth very fast, which some believe to be the result of seeing what the other twin is seeing.

Tatiana and Krista Hogan: Connection Of The Shared Cardiovascular System Tatiana and Krista have shared blood vessels and arteries in the brain. Tatianas heart technically beats for both herself and her sister because 1/5th to 1/4th of the blood supply in Kristas brain comes from Tatianas heart. The responsibility of Tatianas heart to pump blood for two people has caused her to have high blood pressure.

Tatiana and Krista Hogan: Physical Differences and Other Medical IssuesTatiana and Krista are different in size. Tatiana has grown but remains small and very skinny. Krista resembles any normal growing child in size. The girls also had seizures for the first year and a half of their lives but they are both on medication now, so the episodes no longer occur.

Tatiana and Krista Hogan: Separate Personalities Tatiana is more layed back and will do most of what Krista tells her to. Krista is very assertive and somewhat aggressive. It has become a habit for Krista to scratch Tatianas face when Tatiana does not listen to her.

3.)George (Reba) and Lori Schappell

George (Reba) and Lori Schappell: Background InfoGeorge and Lori were born September 18, 1961.There legal names given by their parents were Dori and Lori. Dori resented her parents deeply for giving her and her twin rhyming names so she got her name legally changed to Reba after her favorite country music singer. She now goes by George, although that is not her legal name. They are the oldest living female conjoined twins in the world.They lived in a home for severely mentally ill patients for 24 years.

George (Reba) and Lori Schappell: Connection Of Their BrainsGeorge and Lori share blood vessels connecting their brains.George and Lori share 30% of their brain being that both of their frontal lobes and parietal lobes are connected, but they do have two fully functioning brains that seem to function separately.

George (Reba) and Lori Schappell: Physical ProblemsGeorge has a type of spina bifida that leaves her four inches shorter than her conjoined twin Lori and has also left her paralyzed. She has a stool that she designed herself that allows her to go where her sister goes. Doctors are beginning to think that the gene that causes spina bifida may also be directly related in causing conjoined twins.

George (Reba) and Lori Schappell: Separate Personalities And Goals in LifeGeorge Introverted George is a country singer who won the L.A. Music Award for Best New Country Artist in 1997.Also a trophy winning bowling winner Has designed many mobility machines for handicapped animals and people.Lori Outspoken Extraverted Social Butterfly Works part-time dealing with hotel laundry. Is facilitator to Georges mobility Both George and Lori They both say that the only way they would be separated is if one of them dies and the other stays alive. Then and only then would they even consider being separated.

Answers To The Questions Presented With Trishna and Krishna Answers: There comes a point where you can not separate craniopagus conjoined twins any longer. If they share brain surface or if the have a neural connection between any structures of the brain, they cannot be separated. Questions:

Main Findings Some twins can be separated if they do not share structures of the brain, such as Trishna and Krishna, and have few connecting blood vessels that are not vital to the others blood supply; so you would need the opposite conditions from Tatiana and Kristas case.Some twins can actually share brain structures, which can allow them to have special connections with each others cognition, like in Tatiana and Kristas example of sharing a thalamus and receiving each others sensory impute.

Main Findings Cont. Some twins do not want to be separated, such as in George and Loris case. There may be an underlying gene connected with spina bifida that can also cause conjoined twins. Spina bifida is when the spinal cord does not fully develop leaving gaps in it. Almost just like how conjoined twins are made, where a fertilized egg that splits to form two twins does not split all of the way.

Answering My Initial Question The question was: How is it that craniopagus conjoined twins can have a connected brain but their cognition can be completely separate from the other twin and in all cases, have different personalities? My answer after having done this research would be: Craniopagus twins joint cognition depends on how much of the brain and which parts of the brain have a neural connection between twins. In most cases, craniopagus conjoined twins have two separate brains with all functioning parts that just share blood vessels or brain surface. It is rare, but can happen as we saw, that craniopagus twins share a brain structure, which in this case, they would share more cognition.

Answering My Initial Question Cont. Regarding different personalities, I did not find much information on why personalities are so different among twins with connected brains, I just found that they are. It almost seems that in conjoined twins, there is a greater difference in personality than in just regular siblings but yet there is much better communication and cooperation.

The End

Picture Citations Picture on slide 8: http://www.google.com/imgres?imgurl=http://3.bp.blogspot.com/_P1RHqFsgywM/SwVj2pWBSvI/AAAAAAAAEmw/hFqyiGFr_S8/s1600/baby2.jpg&imgrefurl=http://yesboleh.blogspot.com/2009/11/bangladeshi-twins-stable-after-miracle.html&usg=__PuXFfFKKryB15TO5Ccb66COZSd4=&h=349&w=465&sz=30&hl=en&start=8&zoom=1&tbnid=JOWmSjAlQmHx6M:&tbnh=173&tbnw=222&ei=Ar3eTfvcNorWgQfU2dDnCg&prev=/search%3Fq%3Dtrishna%2Band%2Bkrishna%2Bbefore%2Bthey%2Bwere%2Bseparated%26um%3D1%26hl%3Den%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=931&vpy=207&dur=1430&hovh=194&hovw=259&tx=133&ty=144&page=2&ndsp=10&ved=1t:429,r:4,s:8&biw=1229&bih=508

Picture on slide 9: http://www.google.com/imgres?imgurl=http://o.aolcdn.com/photo-hub/news_gallery/6/3/638114/1258381140090.JPEG&imgrefurl=http://www.aolnews.com/2009/11/16/conjoined-twins-face/&usg=__D5Uu4dduCwBcrMImG6ZmJXRnPBw=&h=304&w=456&sz=28&hl=en&start=0&zoom=1&tbnid=RqYsIKxhHRba8M:&tbnh=165&tbnw=255&ei=Ar3eTfvcNorWgQfU2dDnCg&prev=/search%3Fq%3Dtrishna%2Band%2Bkrishna%2Bbefore%2Bthey%2Bwere%2Bseparated%26um%3D1%26hl%3Den%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=915&vpy=147&dur=595&hovh=183&hovw=275&tx=78&ty=120&page=1&ndsp=8&ved=1t:429,r:3,s:0&biw=1229&bih=508

Picture for slide 10:http://www.google.com/imgres?imgurl=http://www.abc.net.au/reslib/200912/r491312_2551338.JPG&imgrefurl=http://www.abc.net.au/news/stories/2010/07/10/2950146.htm&usg=___pyCsEJ_k_yGqtTT3eGw517OdAs=&h=840&w=563&sz=72&hl=en&start=38&zoom=1&tbnid=kybCik1vwxTe1M:&tbnh=175&tbnw=117&ei=Ar3eTfvcNorWgQfU2dDnCg&prev=/search%3Fq%3Dtrishna%2Band%2Bkrishna%2Bbefore%2Bthey%2Bwere%2Bseparated%26um%3D1%26hl%3Den%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=542&vpy=110&dur=598&hovh=175&hovw=117&tx=74&ty=121&page=5&ndsp=10&ved=1t:429,r:2,s:38&biw=1229&bih=508

Top Picture for slide 15: http://www.google.com/imgres?imgurl=http://4.bp.blogspot.com/_KAPAJNZXLe0/S9X9tWevhII/AAAAAAAAARI/bfDWVU3bFCY/s1600/kt1.jpg&imgrefurl=http://brunchforone.blogspot.com/2010/04/krista-tatiana-hogan-siamese-twin.html&usg=__2YiNpWvM3tVRRb1h8TlMRCQUVpc=&h=416&w=600&sz=89&hl=en&start=0&zoom=1&tbnid=6Dvp2RaATMdapM:&tbnh=117&tbnw=160&ei=mYLfTZGaDITVgAegxpXzCg&prev=/search%3Fq%3Dtatiana%2Band%2Bkrista%2Bhogan%26um%3D1%26hl%3Den%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=285&vpy=69&dur=1175&hovh=187&hovw=270&tx=149&ty=98&page=1&ndsp=18&ved=1t:429,r:1,s:0&biw=1229&bih=508

Bottom Picture for slide 15: http://www.google.com/imgres?imgurl=http://www.anorak.co.uk/wp-content/uploads/Tatiana-and-Krista-Hogan.jpg&imgrefurl=http://www.anorak.co.uk/264603/strange-but-true/tatiana-and-krista-hogan-share-a-brain-vision-and-dreams.html&usg=__8KOkx5HzIHoXEJHUipYYTFqxsQk=&h=303&w=468&sz=20&hl=en&start=0&zoom=1&tbnid=7HLrI6RNtxoVBM:&tbnh=117&tbnw=160&ei=mYLfTZGaDITVgAegxpXzCg&prev=/search%3Fq%3Dtatiana%2Band%2Bkrista%2Bhogan%26um%3D1%26hl%3Den%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=797&vpy=72&dur=156&hovh=181&hovw=279&tx=170&ty=79&page=1&ndsp=18&ved=1t:429,r:4,s:0&biw=1229&bih=508

Picture for slide 19: http://www.google.com/imgres?imgurl=http://1.bp.blogspot.com/_Fe6rGp1YNm8/TGIRZ10xmfI/AAAAAAAAGpU/fQxLHxVU_Q0/s1600/1.jpg&imgrefurl=http://freeamazingimages.com/2010/08/conjoined-twins-share-brain.html&usg=__vHSmugFWi2l-GeYkVEgJu677peA=&h=411&w=531&sz=52&hl=en&start=0&zoom=1&tbnid=Y-PhoNeGJbxxeM:&tbnh=117&tbnw=180&ei=mODeTdPbH4SDgAf-psXmCg&prev=/search%3Fq%3Dtatiana%2Band%2Bkrista%2Bhogan%26um%3D1%26hl%3Den%26sa%3DN%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=rc&dur=475&page=1&ndsp=18&ved=1t:429,r:4,s:0&tx=109&ty=81&biw=1229&bih=508

Pictures from slide 23 captured from: http://www.youtube.com/watch?v=5aBhHfV1dDc

Picture from slide 24:http://www.google.com/imgres?imgurl=http://4.bp.blogspot.com/_Kyg9p1QlyzQ/SlGXFaBrphI/AAAAAAAAAH4/hFAil_hvj9Q/s400/schappell_sisters5.jpg&imgrefurl=http://jekasari.blogspot.com/2009/07/lori-dori-schappell.html&usg=__uQgc2zGIlRxaM_pNshKfiS726zs=&h=400&w=258&sz=24&hl=en&start=0&zoom=0&tbnid=HZiQa8KNczE9TM:&tbnh=119&tbnw=79&ei=0GzfTfvjOcLegQeA7NjkCg&prev=/search%3Fq%3Dgeorge%2Bschappell%2Band%2Bher%2Bwheelchair%26um%3D1%26hl%3Den%26sa%3DX%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=957&vpy=235&dur=472&hovh=124&hovw=80&tx=81&ty=85&page=1&ndsp=24&ved=1t:429,r:14,s:0&biw=1229&bih=508

Picture Citations Cont.

Source CitationsBooksGibbs, Jr., R. W. . (2006). Embodiment and cognitive science . New York, NY: Cambridge University PressOnline Magazine ArticlesHui, Y. (2010, November 9th). Conjoined twins brains connect, share thoughts. Health, Retrieved from http://cogsnews.ucsd.edu/?p=63

MacQueen, K. (2011, May 24). A piece of their mind. Macleans.ca, Retrieved from http://www2.macleans.ca/2010/11/02/a-piece-of-their-mind/print/University Scientific Department BlogBeebout , S. (2009, April 14). Blurring the definition of self, agency, and identity [Web log message]. Retrieved from http://serendip.brynmawr.edu/exchange/node/4158Other Blog WebsitesAnderson, Elizabeth. (2009). phreequeshow [Web log message]. Retrieved from http://www.phreeque.com/schappell_sisters.htmlVideos Extreme Bodies; Separating Cranial Conjoined Twins. How Stuff Works. http://videos.howstuffworks.com/discovery/32215-extreme-bodies-separating-cranial-conjoined-twins-video.htm

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Other Videos Without Production Info.http://www.youtube.com/watch?v=42A0GdmQ02Mhttp://www.youtube.com/watch?v=7pR2uWhAkaQhttp://www.youtube.com/watch?v=5aBhHfV1dDc