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					Craniopagus Conjoined
        Twins
Their Cognition and Separate
      Personality Types
      By: Kelsey Simon
                  Question
• 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?
     Hypothesis…Or Maybe Not
• I didn’t 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 do
• Thalamus- 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 Children’s 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 Separated

                   • Trishna 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
                Connected
• Trishna and Krishna’s 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, Trishna’s blood pressure
  rose while Krishna’s 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 Trishna’s And Krishna’s 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 Info

                       • Tatiana 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 Krista’s 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.
• Tatiana’s heart technically beats for both
  herself and her sister because 1/5th to 1/4th of
  the blood supply in Krista’s brain comes from
  Tatiana’s heart.
• The responsibility of Tatiana’s heart to pump
  blood for two people has caused her to have
  high blood pressure.
Tatiana and Krista Hogan: Physical Differences and Other
                     Medical Issues
• Tatiana 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 Tatiana’s face when
  Tatiana does not listen to her.
3.)George (Reba) and Lori
       Schappell
   George (Reba) and Lori Schappell:
           Background Info
• George 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 Brains
• George 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 Problems
• George 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 Life
George                                     Lori
• Introverted                              • Outspoken
• George is a country singer who
  won the L.A. Music Award for             • Extraverted
  Best New Country Artist in               • Social Butterfly
  1997.
• Also a trophy winning bowling            • Works part-time dealing
  winner                                     with hotel laundry.
• Has designed many mobility               • Is facilitator to George’s
  machines for handicapped
  animals and people.                        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
    Questions:




 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.
               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 Krista’s case.
• Some twins can actually share brain structures,
  which can allow them to have special connections
  with each others cognition, like in Tatiana and
  Krista’s 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 Lori’s 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.j
    pg&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=1
    73&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&tb
    nw=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/new
    s/stories/2010/07/10/2950146.htm&usg=___pyCsEJ_k_yGqtTT3eGw517OdAs=&h=840&w=563&sz=72&hl=en&start=38&zoom=1&tbnid=kybCi
    k1vwxTe1M:&tbnh=175&tbnw=117&ei=Ar3eTfvcNorWgQfU2dDnCg&prev=/search%3Fq%3Dtrishna%2Band%2Bkrishna%2Bbefore%2Bthey%2
    Bwere%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=11
    7&tbnw=160&ei=mYLfTZGaDITVgAegxpXzCg&prev=/search%3Fq%3Dtatiana%2Band%2Bkrista%2Bhogan%26um%3D1%26hl%3Den%26biw%3
    D1229%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
                                                 Picture Citations Cont.

•   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:&tb
    nh=117&tbnw=160&ei=mYLfTZGaDITVgAegxpXzCg&prev=/search%3Fq%3Dtatiana%2Band%2Bkrista%2Bhogan%26um%3D1%26hl%3D
    en%26biw%3D1229%26bih%3D508%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=797&vpy=72&dur=156&hovh=181&hovw=279&tx=1
    70&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%3
    D508%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/scha
    ppell_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:&t
    bnh=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
                                                      Source Citations

                                                                Books
Gibbs, Jr., R. W. . (2006). Embodiment and cognitive science . New York, NY: Cambridge University Press
                                                      Online Magazine Articles
Hui, 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 Blog
Beebout , S. (2009, April 14). Blurring the definition of self, agency, and identity [Web log message]. Retrieved from
     http://serendip.brynmawr.edu/exchange/node/4158
                                                           Other Blog Websites
Anderson, Elizabeth. (2009). phreequeshow [Web log message]. Retrieved from
     http://www.phreeque.com/schappell_sisters.html
                                                                  Videos
“Extreme Bodies; Separating Cranial Conjoined Twins”. How Stuff Works. http://videos.howstuffworks.com/discovery/32215-
     extreme-bodies-separating-cranial-conjoined-twins-video.htm

(2007). Canadian conjoined twins face critical operation [Web]. Available from http://www.liveleak.com

                                       Other Videos Without Production Info.
•    http://www.youtube.com/watch?v=42A0GdmQ02M
•    http://www.youtube.com/watch?v=7pR2uWhAkaQ
•    http://www.youtube.com/watch?v=5aBhHfV1dDc

				
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