Rehabilitation of arithmetic fact retrieval via extensive practice: A combined fMRI and behavioural case-study Luisa Zaunmu ¨ller 1,2 , Frank Domahs 1,3 , Katharina Dressel 1 , Jan Lonnemann 1,3 , Elise Klein 1,3 , Anja Ischebeck 4 , and Klaus Willmes 1,3 1 Department of Neurology, University Hospital, RWTH Aachen University, Germany; 2 Department of Clinical Psychology and Psychotherapy, University of Trier, Trier, Germany; 3 Interdisciplinary Centre for Clinical Research “BioMAT”, RWTH Aachen University, Germany; 4 Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria The present study investigates the effects of a training of arithmetic fact retrie- val in a patient suffering from particular difficulties with multiplication facts. Over a period of four weeks simple multiplication facts were trained exten- sively. The outcome of the training was assessed behaviourally and changes in cerebral activation patterns were investigated using fMRI. The training led to a change in calculation strategies: Prior to training, the patient used predo- minantly time-consuming back-up strategies, after training he relied increas- ingly on the direct retrieval of arithmetic facts from long-term memory. Regarding the fMRI results, prefrontal activations were observed for untrained problems, which can be attributed to the application of back-up strategies strongly relying on fronto-executive functions. Interestingly, significant foci of activation for both trained and untrained items were found in the angular gyrus of the right hemisphere, which, however, differed in their exact Correspondence should be sent to Luisa Zaunmu ¨ller, Section Neuropsychology, Department of Neurology, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany. Email: zaunmueller@neuropsych.rwth-aachen.de We would like to thank patient WT for his willingness to take part in this investigation. This project was supported by the START programme of the Faculty of Medicine at the RWTH- Aachen University (AZ 160/05) and by a grant from the Interdisciplinary Centre for Clinical Research “BIOMAT” within the Faculty of Medicine at the RWTH Aachen University (VV N69c). NEUROPSYCHOLOGICAL REHABILITATION 0000, 00 (0), 1–22 # 2008 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business http://www.psypress.com/neurorehab DOI:10.1080/09602010802296378 Downloaded By: [Zaunmüller, Luisa] At: 07:53 27 October 2008