Electroacupuncture (EA) is a safe and effective method for treating obesity. However, how it modulates reward-related brain activity/functional connectivity and gut hormones remains unclear. We employed resting-state functional magnetic resonance imaging (RS-fMRI) and resting-state functional connectivity (RSFC) to investigate EA induced changes in resting-state activity and RSFC in reward-related regions and its association with gut hormones in overweight/obese subjects who received real (n = 20) and Sham (n = 15) stimulation. Results showed reduced leptin levels was positively correlated with reduced body mass index (BMI) and negatively correlated with increased cognitive-control as measured with Three-Factor-Eating-Questionnaire (TFEQ). Significant time effects on RSFC between dorsal caudate (DC) and precuneus were due to significant increased RSFC strength in both EA and Sham groups. In addition, increased RSFC of DC-precuneus was negatively correlated with reduced BMI and leptin levels in the EA group. Mediation analysis showed that the relationship between increased DC-precuneus RSFC strength and reduced BMI was mediated by reduced leptin levels. These findings reflect the association between EA-induced brain reward-related RSFC and leptin levels, and decreased leptin levels mediated altered DC-precuneus RSFC strength and consequent weight-loss, suggesting the potential role of EA in reducing weight and appetite.

电针（EA）是治疗肥胖的一种安全有效的方法。然而，它如何调节与奖励相关的大脑活动/功能连接和肠道激素仍不清楚。我们采用静息状态功能磁共振成像 (RS-fMRI) 和静息状态功能连接 (RSFC) 来研究 EA 在奖赏相关区域中诱导的静息状态活动和 RSFC 的变化及其与超重/肥胖中肠道激素的关系接受真实（n  = 20）和假（n = 15) 刺激。结果显示，瘦素水平降低与体重指数（BMI）降低呈正相关，与三因素饮食问卷（TFEQ）测量的认知控制增加呈负相关。背尾状核 (DC) 和楔前叶对 RSFC 的显着时间影响是由于 EA 和 Sham 组的 RSFC 强度显着增加。此外，在 EA 组中，DC-precuneus 增加的 RSFC 与降低的 BMI 和瘦素水平呈负相关。中介分析表明，DC-楔前叶 RSFC 强度增加与 BMI 降低之间的关系是由瘦素水平降低介导的。这些发现反映了 EA 诱导的大脑奖赏相关 RSFC 和瘦素水平之间的关联，瘦素水平降低介导了 DC-楔前叶 RSFC 强度的改变和随之而来的体重减轻，