Altered Fetal Cerebral and Cerebellar Development in Twin-Twin Transfusion Syndrome

Abstract

BACKGROUND AND PURPOSE:Neurodevelopmental disability is common in twins with TTTS in utero; however, the responsible neuropathology remains uncertain. We proposed to document the frequency of brain abnormalities on clinical fetal MR images and to determine if quantitative fetal brain biometric analysis in twin fetuses with TTTS was different from those in healthy control fetuses.

Prematurity and twinning

“…MR imaging revealed persistently small measurements in the donor cerebrum and cerebellum in comparison with their recipient co-twin and healthy control foetuses [23]. Periventricular white matter lesions (WMLs) and persistent ventriculomegaly in particular have been associated with an adverse neurodevelopmental outcome.…”

Congenital cytomegalovirus infection in monozygotic twins with twin-to-twin transfusion syndrome

“…Intrauterine hemodynamics between the donor and recipient was the only difference that could be recognized, and these were considered to be an important factor for the discordant manifestations in our patients. A decrease in circulating blood volume of the twin-to-twin transfusion syndrome donor leads to intracranial hypoperfusion and brain dysplasia [8]. Because hypoperfusion results in damage to neuronal cells and the blood-brain barrier, the central nervous system of the donor may become more susceptible to CMV invasion.…”

Solvent Exposure and Parkinson's Disease: Co-Twin Control Study/ Twin Research Reports / Human Interest Stories

“…It estimated that the co-twins in 10-20% of monochorionic pregnancies are affected by an imbalance in circulation between the donor (depletion) and recipient (excess). A recent retrospective study compared the brain images of 33 twin pairs that included 18 healthy twins (Tarui et al, 2012). The aim was to compare the frequency of brain abnormalities and quantitative biometrical parameters between the healthy and affected infants, and with healthy controls.…”