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Thus, we hypothesized that amygdala nuclei alterations might be associated with AN\u2010related rumination and potentially mediate the leptin\u2010rumination relationship in AN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Rumination (food\u2212\/weight\u2010related) was assessed using ecological momentary assessment for a 14\u2010day period. We employed frequentist and Bayesian linear mixed effects models in females with AN (<jats:italic>n<\/jats:italic>\u2009=\u200951, 12\u201329\u2009years, majority admitted to inpatient treatment) and age\u2010matched healthy females (<jats:italic>n<\/jats:italic>\u2009=\u200951) to investigate associations between rostral\u2010medial amygdala nuclei volume alterations (accessory basal, cortical, medial nuclei, corticoamygdaloid transitions) and rumination. We analyzed mediation effects using multi\u2010level structural equation models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Reduced right accessory basal and cortical nuclei volumes predicted more frequent weight\u2010related rumination in AN; both nuclei fully mediated the effect of leptin on weight\u2010related rumination. In contrast, we found robust evidence for the absence of amygdala nuclei volume effects on rumination in healthy females.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides first evidence for the relevance of specific amygdala substructure reductions regarding cognitive symptom severity in AN and points toward novel mechanistic insight into the relationship between hypoleptinemia and rumination, which might involve the amygdaloid complex. Our findings in AN may have important clinical value with respect to understanding the beneficial neuropsychiatric effects of leptin (treatment) in AN and potentially other psychiatric conditions such as depression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.13607","type":"journal-article","created":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T05:05:27Z","timestamp":1694235927000},"page":"368-381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Explicating the role of amygdala substructure alterations in the link between hypoleptinemia and rumination in anorexia nervosa"],"prefix":"10.1111","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3907-6630","authenticated-orcid":false,"given":"Marie\u2010Louis","family":"Wronski","sequence":"first","affiliation":[{"name":"Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, 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