The Supreme Court on Tuesday upheld the death penalty for Tsutomu Miyazaki in the brutal late-1980s serial killings of four girls in Tokyo and Saitama Prefecture that stunned the nation.

The focus of the case was whether Miyazaki, 43, was mentally competent at the time of the crimes. He was sentenced to death by the Tokyo District Court in April 1997 and the Tokyo High Court upheld the ruling in June 2001.

Presiding Justice Tokiyasu Fujita rejected the defense argument that Miyazaki was mentally incompetent at the time of the crimes. He ruled that although Miyazaki has an extreme character disorder, it is not one that absolves him of criminal responsibility.