Forensic neuroimaging in childhood abduction, rape and murder case and trial outcome

Impulse control can be affected by factors including neurological disorders or developmental experiences. As such, a combination of neurodegenerative disorder, neurodevelopmental disorder, and childhood abuse can potentially lead a person to commit violent crimes. In this case report, we discuss the case details, biopsychosocial history, and neuroimaging of 61-year-old Donald Smith who was convicted for kidnapping, sexual assault, and murder of an eight-year-old girl. Using quantitative volumetric analysis, fluorodeoxyglucose positron emission tomography, and diffusion tensor imaging, we found neurologic evidence consistent with traumatic encephalopathy syndrome, autism spectrum disorder and neurological sequelae of adverse childhood experiences, which aligned with Smith's neuropsychiatric testing and reported personal and medical history. Although evidence of neurological structural abnormalities has influenced mitigations in previous homicide trials, in this case, Smith was sentenced to death. We explore neurological underpinnings that could have led to his deviant behaviour, along with a discussion regarding reasons behind the final verdict.