Doctors give mixed testimony on whether tests show brain damage in the Pittsburgh synagogue killer

Jurors considering a death sentence for Pittsburgh synagogue killer Robert Bowers heard mixed testimony from doctors on Tuesday about whether medical scans showed any significant brain damage — a central point of contention in his lawyers' strategy to spare his life.

The testimony came on the second day of the penalty phase in the case against Bowers, who was convicted this month of killing 11 worshippers from three congregations during the 2018 mass shooting that was the deadliest antisemitic attack in U.S. history.

The testimony came in two batches, the first of which included the findings of three local doctors who reviewed the results of various brain scans, not knowing they were Bowers', and found them to be largely normal with some signs of possible seizures or other problems.

Two expert witnesses for the defense, though, had a different take on the test results, saying they showed that Bowers had significant brain damage that could be correlated with schizophrenia and would damage Bowers' ability to manage emotions, stress and conflict.

Dr. Murray Arthur Solomon, a California doctor who testified remotely, said an MRI showed multiple lesions on the white matter in Bowers' brain, more than would be expected of a man of his age. These could be associated with problems with reasoning and making decisions, he said. “That’s a red flag when you see a large number of lesions,” said Solomon, testifying as an expert in radiology.

The sentencing phase is expected to take four or five weeks. Prosecutors would first have to prove the case is eligible for the death penalty — by proving Bowers intended to carry out the attack — before the jury could consider multiple factors on whether to actually impose that sentence.

Prosecutors say there's extensive evidence of intent — that Bowers raged against Jews online and at the scene of the attack on Oct. 27, 2018, at the Tree of Life synagogue in the Squirrel Hill neighborhood, the hub of Pittsburgh's Jewish community. Bowers, 50, a truck driver from suburban Baldwin, killed 11 worshippers from the Dor Hadash, New Light and Tree of Life congregations, which shared the building.

But defense lawyers argue that Bowers' ability to form intent was impaired by mental illness, claiming symptoms of epilepsy and schizophrenia.

Three doctors from the University of Pittsburgh Medical Center testified Tuesday that they conducted separate analyses of brain-imaging tests testing done of Bowers in 2021 and 2022. None of them knew the patient was Bowers at the time, noting that they review hundreds or thousands of such test results.

Dr. Vijayalakshmi Rajasekaran, an assistant professor of neurology at the University of Pittsburgh, testified that an EEG — which measured two days of brain activity — showed some abnormalities in Bowers’ brain waves, indicating a potential tendency to seizures. But the test didn’t record any actual seizures, and she said the test can’t predict with certainty whether a patient ever had or will have a seizure.

Dr. Joseph Mettenburg, an associate professor or radiology at Pitt who reviewed the MRI scan of Bowers, testified that he found some “white matter hyperintensities” — irregularities that could be seen with migraines or similar problems related to blood flow. But overall, he said the results showed a normal brain.

Dr. James Michael Mountz, a professor of radiology at Pitt, said he didn’t see signs of epilepsy on a PET scan of Bowers.

However, Dr. Andrew Newberg of Thomas Jefferson University Hospital, testifying on behalf of the defense as an expert in nuclear medicine and brain imaging, testified that the PET scan showed that numerous areas of Bowers’ brain were either overactive or underactive, beyond the normal range of most brains, and that the left side of his brain was far more active than the right.

“It suggests there is a substantial imbalance in the brain,” he said, adding that there is dysfunction in parts of the brain managing stress, emotions and perceived threats. There will not be the ability to process thoughts or feelings “as effectively as you would if you had a balanced brain,” Newberg said.

He said schizophrenia has been associated with abnormal brain asymmetries, but he acknowledged under cross-examination that there’s no direct way to scan for schizophrenia.

U.S. Attorney Eric Olshan asked Newberg if the person whose brain generated the images in question is capable of killing another person.

“I don’t think that really can be answered on the basis of a PET scan,” Newberg acknowledged.

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