Despite the relative scarcity of studies focusing on
pharmacotherapy in
aphasia, there is evidence in the literature indicating that remediation of
language disorders via
pharmaceutical agents could be a promising
aphasia treatment option. Among the various agents used to treat chronic aphasic deficits,
cholinergic drugs have provided meaningful results. In the current review, we focused on published reports investigating the impact of
acetylcholine on language and other cognitive disturbances. It has been suggested that
acetylcholine plays an important role in neuroplasticity and is related to several aspects of cognition, such as memory and attention. Moreover,
cholinergic input is diffused to a wide network of cortical areas, which have been associated with language sub-processes. This could be a possible explanation for the positive reported outcomes of
cholinergic drugs in
aphasia recovery, and specifically in distinct language processes, such as naming and comprehension, as well as overall communication competence. However, evidence with regard to functional alterations in specific brain areas after
pharmacotherapy is rather limited. Finally, despite the positive results derived from the relevant studies,
cholinergic pharmacotherapy treatment in post-
stroke aphasia has not been widely implemented. The present review aims to provide an overview of the existing literature in the common neuroanatomical substrate of
cholinergic pathways and language related brain areas as a framework for interpreting the efficacy of
cholinergic pharmacotherapy interventions in post-
stroke aphasia, following an integrated approach by converging evidence from neuroanatomy, neurophysiology, and neuropsychology.