When writing 0 (zero) is easier than writing O (o): a neuropsychological case study of agraphia

Though a few case studies reported a dissociation between intact writing of Arabic and impaired writing of alphabetical script, a detailed experimental analysis of such a dissociation is still lacking. We report a follow-up study of a patient with a parieto-occipital lesion who is affected by severe peripheral agraphia for letters, but not for Arabic digits. While letters in writing to dictation are frequently illegible, distorted, or consist in meaningless strokes, Arabic digits are well-formed and fluently produced. In a series of tasks, including copying of letters with tachistoscopic presentation and handwriting on a digitizing tablet, several processing levels are assessed in order to localize JS' functional writing impairment and to determine different processing routes for letters and for numbers. Overall, the results of the experimental investigation suggest a notation specific deficit in the activation of graphomotor patterns for letters, but not for digits. The study thus adds evidence to the so far reported dissociations between Arabic and alphabetical scripts.