The suspect in the Tucson shooting rampage that wounded U.S. Rep. Gabrielle Giffords appears in court Wednesday for a hearing to determine whether he is mentally competent to stand trial and assist in his defense.

Jared Lee Loughner spent five weeks in March and April at a federal facility in Springfield, Mo., where two court-appointed mental health professionals examined him to determine whether he understands the consequences of the case against him. The competency reports by psychologist Christina Pietz and psychiatrist Matthew Carroll haven't been publicly released.

It's up to U.S. District Judge Larry Burns, who is holding the hearing in Tucson, to decide whether Loughner is competent to stand trial.

The case will continue to move forward if the judge determines Loughner is mentally competent. If he is found to be mentally incompetent, he would be sent to a federal facility for a maximum of four months to see if he can be restored to competency.

Loughner, 22, has pleaded not guilty to 49 federal charges stemming from the Jan. 8 shooting at a meet-and-greet event that wounded Giffords and 12 others and killed six people, including a 9-year-old girl and a federal judge.

Prosecutors had asked for the mental exam of Loughner, citing a YouTube video in which they believe a hooded Loughner wore garbage bags and burned an American flag.