Chao Ke ^* Wenying Shi ^* Zhuo Zhou ^* Zhengrong Xie ^* Mengzi Sun ^* Juli Yu ^* Shengtao Shan ^* Wei Zhang ^*

• The First Hospital of Hunan University of Chinese Medicine, Changsha, China

Background: Stroke is a neurological condition characterised by high rates of disability and mortality. Magnetic resonance imaging (MRI) is widely used to examine the mechanisms of acupuncture in stroke treatment. Purpose: This review provides neuroimaging evidence for the efficacy of acupuncture in treating stroke using MRI. Method: We conducted a comprehensive search of databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Data, Chinese BioMedical Literature Database (CBM), and Chonqing VIP (CQVIP), from inception to April 2024. Relevant neuroimaging studies on acupuncture for stroke were included, and the research findings were presented through charts and textual analyses. Results: A total of 158 studies were included, and the overall methodological quality of the included studies was moderate to high. The results were divided into two categories: basic characteristics and clinical characteristics. Conclusion: We elucidated the neural mechanisms underlying the effects of acupuncture on stroke; however, the evidence remains preliminary. There is a need for large-scale, well-designed, multimodal neuroimaging trials. This review represents the first active use of an evidence map to systematically review and illustrate the current state of neuroimaging research on the acupuncture treatment of stroke, thereby providing a valuable reference for future research.