Garrett-Bakelman · Science (New York, N.Y.) 2019 · longitudinal monozygotic twin case-control study · n=2

The NASA Twins Study: A multidimensional analysis of a year-long human spaceflight.

Cited 1144 times in the scientific literature.

Level 4 - case-series / case-control

Longitudinal twin study comparing a single spaceflight astronaut to a single genetically matched ground control

PubMed 30975860 · doi:10.1126/science.aau8650 · record verified 2026-08-31

What was done

One monozygotic twin astronaut was longitudinally monitored before, during, and after a 1-year mission aboard the International Space Station, while his identical twin remained on Earth as a genetically matched ground control. The study evaluated multiomic, physiological, molecular, and cognitive outcomes across both subjects.

What was found

The abstract reports no exact numeric values. Observed spaceflight-specific changes included decreased body mass, in-flight telomere elongation, genome instability, carotid artery distension, increased carotid intima-media thickness, ocular structural changes, transcriptional and metabolic shifts, altered DNA methylation in immune and oxidative stress pathways, altered gut microbiota, and postflight cognitive decline. Within 6 months post-landing, average telomere length, global gene expression, and microbiota composition returned near baseline, though an increased frequency of short telomeres and persistent disruption of some gene expression remained.

Why it matters

This study provides an unprecedented multiomic catalog of how year-long spaceflight affects human biology relative to a genetically identical terrestrial control, identifying candidate physiological risks for future long-duration exploration missions.

Limits

The sample size is limited to one astronaut and one control twin (n=2), preventing statistical generalization to broader populations or separation of idiosyncratic responses from universal spaceflight physiology. Uncontrolled environmental variables between flight and ground environments could not be fully matched.

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