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However, it is currently unknown which thalamic nuclei and how nuclear\u2010specific thalamocortical functional connectivity are differentially impacted in patients with medically refractory and non\u2010refractory idiopathic generalised epilepsy (IGE). In the present study, we performed structural and resting\u2010state functional magnetic resonance imaging (MRI) in patients with refractory and non\u2010refractory IGE, segmented the thalamus into constituent nuclear regions using a probabilistic MRI segmentation method and determined thalamocortical functional connectivity using seed\u2010to\u2010voxel connectivity analyses. We report significant volume reduction of the left and right anterior thalamic nuclei only in patients with refractory IGE. Compared to healthy controls, patients with refractory and non\u2010refractory IGE had significant alterations of functional connectivity between the centromedian nucleus and cortex, but only patients with refractory IGE had altered cortical connectivity with the ventral lateral nuclear group. Patients with refractory IGE had significantly increased functional connectivity between the left and right ventral lateral posterior nuclei and cortical regions compared to patients with non\u2010refractory IGE. Cortical effects were predominantly located in the frontal lobe. Atrophy of the anterior thalamic nuclei and resting\u2010state functional hyperconnectivity between ventral lateral nuclei and cerebral cortex may be imaging markers of pharmacoresistance in patients with IGE. These structural and functional abnormalities fit well with the known importance of thalamocortical systems in the generation and maintenance of primary generalised seizures, and the increasing recognition of the importance of limbic pathways in IGE.<\/jats:p>","DOI":"10.1002\/hbm.25644","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T14:06:38Z","timestamp":1629900398000},"page":"5648-5664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Probabilistic mapping of thalamic nuclei and thalamocortical functional connectivity in idiopathic generalised epilepsy"],"prefix":"10.1002","volume":"42","author":[{"given":"Yachin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Therapeutics Institute of Systems, Molecular and Integrative Biology, University of Liverpool  Liverpool UK"},{"name":"The Walton Centre NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Fallon","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A. 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