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New automated structural magnetic resonance imaging (MRI) segmentation tools facilitate the<jats:italic>in vivo<\/jats:italic>study of individual amygdala nuclei in clinical populations such as patients with anorexia nervosa (AN) who show symptoms indicative of limbic dysregulation. This study is the first to investigate amygdala nuclei volumes in AN, their relationships with leptin, a key indicator of AN-related neuroendocrine alterations, and further clinical measures.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722003609_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>T1-weighted MRI scans were subsegmented and multi-stage quality controlled using FreeSurfer. Left\/right hemispheric amygdala nuclei volumes were cross-sectionally compared between females with AN (<jats:italic>n<\/jats:italic>= 168, 12\u201329 years) and age-matched healthy females (<jats:italic>n<\/jats:italic>= 168) applying general linear models. Associations with plasma leptin, body mass index (BMI), illness duration, and psychiatric symptoms were analyzed via robust linear regression.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722003609_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Globally, most amygdala nuclei volumes in both hemispheres were reduced in AN<jats:italic>v.<\/jats:italic>healthy control participants. Importantly, four specific nuclei (accessory basal, cortical, medial nuclei, corticoamygdaloid transition in the rostral-medial amygdala) showed greater volumetric reduction even relative to reductions of whole amygdala and total subcortical gray matter volumes, whereas basal, lateral, and paralaminar nuclei were less reduced. All rostral-medially clustered nuclei were positively associated with leptin in AN independent of BMI. Amygdala nuclei volumes were not associated with illness duration or psychiatric symptom severity in AN.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722003609_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>In AN, amygdala nuclei are altered to different degrees. Severe volume loss in rostral-medially clustered nuclei, collectively involved in olfactory\/food-related reward processing, may represent a structural correlate of AN-related symptoms. Hypoleptinemia might be linked to rostral-medial amygdala alterations.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291722003609","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T03:51:10Z","timestamp":1670212270000},"page":"6288-6303","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":24,"title":["Differential alterations of amygdala nuclei volumes in acutely ill patients with anorexia nervosa and their associations with leptin 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