Acalculia from a right hemisphere lesion dealing with "where" in multiplication procedures

The present study describes in detail, for the first time, a case of failure with multiplication procedures in a right hemisphere damaged patient (PN). A careful, step-by-step, error analysis made possible to show that an important portion of PN's errors could be better explained as spatial in nature and specifically related to the demands of a multi-digit multiplication. These errors can be distinguished from other types of errors, including those, expected after a right hemisphere lesion, determined by a generic inability to deal with spatial material, or from other deficits, like neglect, affecting cognitive capacities across the board. The best explanation for PN's problems is that he might have difficulties in relying on a visuo-spatial store containing a layout representation specific to multiplication. As a consequence, while knowing what, when and how to carry out the various steps, PN does not know where. What he may thus lack is a spatial schema of multiplication. Such schema is thought to help normal calculators in overcoming working memory demands of complex calculation by representing the information of where exactly each sub-step should be placed.