Abstract: OBJECTIVE To investigate the therapeutic mechanism of rivastigmine related to brain function by regional homogeneity(ReHo) in Alzheimer's disease(AD) patients. METHODS Treatment with rivastigmine was performed in 9 mild and moderate AD patients for 24 weeks. Before and after the treatment, they received comprehensive neuropsychological assessments and resting-state functional magnetic resonance imaging respectively. Meanwhile, resting-state functional magnetic resonance imaging was conducted on the healthy control group including 9 healthy individuals with the same age, gender and education with the aforesaid 9 AD patients, in an attempt to compare the changes in brain ReHo among the AD patients before and after the treatment with rivastigmine. RESULTS Compared with before treatment, after treatment of AD patients had an increase in their mini-mental state examination scores(P<0.05), while a decrease in scores of AD assessment scale-cognitive section and activity of daily living scale(P<0.05). The AD patients showed ReHo values reduced in the medial part of the left superior frontal gyrus, the medial orbital part of the left superior frontal gyrus and the right amygdala(P<0.05). In addition, the changes in scores of AD assessment scale-cognitive section were positive correlated with the ReHo values of the medial orbital part of the left superior frontal gyrus. CONCLUSION These findings suggest that rivastigmine's able to improve cognitive abilities of AD patients which may be achieved by altering spontaneous cerebration of the medial part of the superior frontal gyrus and the amygdala. Relevant brain regions are likely to serve as the biomarker for monitoring therapeutic effects of this kind of drugs in the future.