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OBJECTIVE:To determine differences in cerebral activity evoked by acupuncture and conventional stroke treatment,and identify the treatment targets.METHODS:In total,21 patients were randomly divided into two groups.Group A (11 patients) received both acupuncture and conventional treatment,while group B (10 patients) received conventional treatment only.Resting-state functional magnetic resonance imaging (fMRI) was performed on each participant before and after treatment.Regional homogeneity analysis was performed to investigate the potential mechanism of acupuncture treatment by comparing differences in cerebral activity between treatments.RESULTS:Group A showed higher ReHo in the frontal lobe (BA6,BA46),supra-marginal gyrus (BA40),middle temporal gyrus (BA21),cerebellum,and insula.Group B showed higher ReHo in the frontal lobe (BA6) and parietal lobe (BA3,BA7).CONCLUSION:Acupuncture and conventional treatment triggered relatively different clinical efficacy and brain responses.Acupuncture treatment more significantly improved the symptoms of stroke patients.More marked changes in sensory,emotional,and motor areas (including the frontal lobe,middle temporal gyrus,cerebellum,and insula) might reflect the specific acupuncture mechanism.