As the worldwide population ages

the prevalence of Alzheimer's disease (AD) increases. However

the results of promising medications have been unsatisfactory. Chinese acupuncture has a long history of treating dementia

but lack of evidence from well-designed randomized controlled trials that validate its efficacy and safety

as well as its lack of clear underlying mechanisms

contribute to its limited application in clinical practice. In recent years

brain imaging technologies

such as functional magnetic resonance imaging and positron emission tomography

have been used to assess brain responses to acupuncture in a dynamic

visual

and objective way. These techniques are frequently used to explore neurological mechanisms of responses to acupuncture in AD and provide neuroimaging evidence as well as starting points to elucidate the possible mechanisms. This review summarizes the existing brain imaging evidence that explains the effects of acupuncture for AD and analyzes brain responses to acupuncture at cognitive-related acupoints [Baihui (GV 20)

Shenmen (HT 7)

Zusanli (ST 36)

Neiguan (PC 6)

and Taixi (KI 3)] from perspectives of acupoint specificity and acupoint combinations. Key issues and directions to consider in future studies are also put forward. This review should deepen our understanding of how brain imaging studies can be used to explore the underlying mechanisms of acupuncture in AD.