Identifying and Treating Arousal Related Deficits in Neglect and Dysphagia

Inclusion Criteria

• Signed informed consent
• Willingness to complete study procedures
• Ability to comprehend and sign informed consent
• Evidence of unilateral, ischemic stroke based on:
• Neuroimaging (clinically obtained imaging studies showing evidence of stroke)
• Acceptable categories of stroke include:
• Unilateral ischemic stroke
• Atherothrombotic stroke
• Cardioembolic stroke
• Lacunar stroke >1.5 cm
• Chronic stable, unilateral hemorrhagic stroke
• Or Behavioral evidence of stroke including:
• Hemiplegia
• Unilateral sensory impairment
• Localized higher cortical dysfunction (e.g. neglect, dysphagia, apraxia)

Exclusion Criteria

• Cardiac valvular disease
• Left heart hypertrophy
• Poorly controlled hypertension
• Active variant angina
• Pre-menopausal women capable of having children, including those using active contraception (precaution for study medication and not applicable to normal subjects)
• Severe renal or hepatic disease
• History of psychosis or substance abuse
• Patients on other Central Nervous System (CNS) stimulants, dopamine agonists or antagonists (antipsychotics)
• Severe speech comprehension deficit and/or inability to communicate responses
• Allergies that could put the research subject at risk during the course of the study
• Cannot speak English
• Active cerebral neurologic disease other than stroke such as multiple sclerosis or Alzheimer's Disease
• Active psychiatric illness except past history of treated depression or anxiety disorders
• For persons needing an MRI - standard MRI exclusion criteria (cardiac pacemaker or defibrillator, artificial heart valves, metallic aneurysm clips eye or ear implants, implanted insulin or infusion pumps, battery activated stimulators, and history of claustrophobia)
• Concomitant medications excluded: Based on recommendations of manufacturer, the following concomitant medications are excluded: Tricyclic antidepressants and Monoamine oxidase (MAO) inhibitors. Any other CNS stimulation producing medications. Antifungal agents Itraconazole or Ketoconazole as plasma concentrations of modafinil may be increased.
• Stroke patients will be excluded from the modafinil trial if they cannot swallow a capsule.
• Stroke patients are excluded if they are able to become pregnant
• Any other criteria that the PI or study physicians feel would put the volunteer's health at risk during the course of the study