Understanding dissociations in dyscalculia: a brain imaging study of the impact of number size on the cerebral networks for exact and approximate calculation.

Neuropsychological studies have revealed different subtypes of dyscalculia, including dissociations between exact calculation and approximation abilities, and an impact of number size on performance. To understand the origins of these effects, we measured cerebral activity with functional MRI at 3 Tesla and event-related potentials while healthy volunteers performed exact and approximate calculation tasks with small and large numbers. Bilateral intraparietal, precentral, dorsolateral and superior prefrontal regions showed greater activation during approximation, while the left inferior prefrontal cortex and the bilateral angular regions were more activated during exact calculation. Increasing number size during exact calculation led to increased activation in the same bilateral intraparietal regions as during approximation, as well the left inferior and superior frontal gyri. Event-related potentials gave access to the temporal dynamics of calculation processes, showing that effects of task and of number size could be found as early as 200-300 ms following problem presentation. Altogether, the results reveal two cerebral networks for number processing. Rote arithmetic operations with small numbers have a greater reliance on left-lateralized regions, presumably encoding numbers in verbal format. Approximation and exact calculation with large numbers, however, put heavier emphasis on the left and right parietal cortices, which may encode numbers in a non-verbal quantity format. Subtypes of dyscalculia can be explained by lesions disproportionately affecting only one of these networks.