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Analysis of intracerebral recordings showed that subcortical structures, and in particular the thalamus, play an important role in seizure dynamics as well, supporting their structural alterations reported in the neuroimaging literature. Nonetheless, between\u2010patient differences in EZN localization (e.g., temporal vs. non\u2010temporal lobe epilepsy) as well as extension (i.e., number of epileptogenic regions) might impact the magnitude as well as spatial distribution of subcortical structural changes. Here we used 7\u2009Tesla MRI T<jats:sub>1<\/jats:sub> data to provide an unprecedented description of subcortical morphological (volume, tissue deformation, and shape) and longitudinal relaxation (T<jats:sub>1<\/jats:sub>) changes in focal epilepsy patients and evaluate the impact of the EZN and other patient\u2010specific clinical features. Our results showed variable levels of atrophy across thalamic nuclei that appeared most prominent in the temporal lobe epilepsy group and the side ipsilateral to the EZN, while shortening of T<jats:sub>1<\/jats:sub> was especially observed for the lateral thalamus. Multivariate analyses across thalamic nuclei and basal ganglia showed that volume acted as the dominant discriminator between patients and controls, while (posterolateral) thalamic T<jats:sub>1<\/jats:sub> measures looked promising to further differentiate patients based on EZN localization. In particular, the observed differences in T<jats:sub>1<\/jats:sub> changes between thalamic nuclei indicated differential involvement based on EZN localization. Finally, EZN extension was found to best explain the observed variability between patients. To conclude, this work revealed multi\u2010scale subcortical alterations in focal epilepsy as well as their dependence on several clinical characteristics.<\/jats:p>","DOI":"10.1002\/hbm.26414","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T13:15:59Z","timestamp":1689167759000},"page":"4754-4771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Multi\u2010scale structural alterations of the thalamus and basal ganglia in focal epilepsy using <scp>7T MRI<\/scp>"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8543-2467","authenticated-orcid":false,"given":"Roy A. 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