Cortical areas differentially involved in multiplication and subtraction: a functional magnetic resonance imaging study and correlation with a case of selective acalculia.

A patient with an intracranial hemorrhage showed differential impairment among arithmetic types (impaired in multiplication but not in subtraction). A functional magnetic resonance imaging (fMRI) experiment using normal volunteers also revealed a differential activation between the two arithmetic types. The fMRI result could account for the selective acalculia of the patient in that the lesion shown by structural MRI included the region with multiplication-higher activation and spared subtraction-higher regions. These findings suggest that the cognitive mechanism and neural substrates differ among the simple arithmetic operations.