Chronic disability following stroke is a significant problem for Veterans affecting a variety of daily activities. One area of importance is the impact of stroke on driving safety. With technology for fully autonomous driving vehicles still decades away from implementation, it is critical that we ensure a safe return to driving in our Veterans following brain injury. Evaluation of Veterans’ driving skills in a driving simulator is a safe and low-cost procedure that has been shown to correlate highly with on-road testing. In our prior Merit project, we have established that stroke patients with a wide range of deficits can successfully complete simulated driving assessments and we have shown that brain injuries involving the left versus right cerebral hemisphere result in very different patterns of driving errors (e.g., lane deviations, collisions, and speeding). We also found that measures of executive functioning and visuospatial abilities are more predictive of driving performance than other factors such as age, visual acuity, and simple reaction time. Our data thus far suggest a need for driving evaluations that can target specific driving skills related to specific cognitive abilities, a key step towards the goal of precision-medicine at the VA, which strives to tailor care and treatment to the specific needs of individual patients. The current project will address this need by evaluating stroke patients on a state-of-the-art driving simulator in which specific driving skills (lane positioning, speed management, and accident avoidance) will be individually assessed in separate driving modules. These specific driving skills will be related to performance on cognitive tasks in order to identify which cognitive functions are consistently associated with specific aspects of driving. In addition, we will examine whether several common driver-assist features (e.g., lane departure and collision warnings) are helpful or harmful to individuals recovering from stroke. Lastly, we will investigate the neural correlates of specific driving skills using lesion symptom mapping techniques, which relate specific brain regions to behavioral performance. Participants will include 40 left and 40 right hemisphere Veteran stroke patients with no prior neurologic or severe psychiatric history, and 20 age- and education-matched Veterans with no neurologic or psychiatric history (controls). We will use a state-of-the-art driving simulator that has been demonstrated to have strong ecological and predictive validity with respect to on-road driving fitness. It is predicted that left hemisphere stroke patients will exhibit greater impairment in speed control and that performance on this skill will correlate with attentional monitoring capacity and executive functioning measures (e.g., Trailmaking). Right hemisphere stroke patients, in contrast, are predicted to have greater difficulty with lane positioning and collision avoidance, which is expected to correlate with visu...