BACKGROUND: Little research has been done on the connection between functional status and acupuncture efficacy; however, functional status is a key factor in the study of acupuncture efficacy. Therefore, we have tried to compare functional dyspepsia (FD) patients with healthy subjects (HS) to determine the different cerebral responses elicited by acupuncture stimulation at Zusanli (ST36). PATIENTS AND METHODS: IN this study, 24 FD patients and 24 HS were given acupuncture stimulation at ST36 while being monitored by an fMRI scan. RESULTS: Compared with HS, FD patients showed an fMRI signal decrease in the right anterior cingulate cortex, right medial prefrontal cortex, right orbitofrontal cortex, left superior occipital gyrus, and right cuneus; but on the other hand, there was an fMRI signal increase in the right insula, right postcentral gyrus, and right supramarginal gyrus. CONCLUSION: Acupuncture stimulation at ST36 evoked pronounced changes, especially in the homeostatic afferent processing network of FD patients, compared to HS. We hypothesize that the cerebral responses elicited by acupuncture stimulation in certain diseases, such as FD are correlated to specific regions. The action of stimulating acupoints might be dynamic; the functional status is therefore an essential impact factor for cerebral responses to acupuncture stimulation.