PURPOSE: This article aims to explore the relationship between the symptoms of PMS and changes of thalamic subregions. METHODS AND MATERIALS: 71 patients diagnosed with PMS and 81 healthy controls (HCs) were included in the study. Participant status was determined using the Daily Record of Severity of Problems (DRSP) scale. All participants underwent functional and structural scans, and peripheral venous blood samples were collected to assess the cytokine and hormone levels. Resting-state functional connectivity (rsFC) and grey matter volume (GMV) of thalamic subregions were calculated from the MRI data. Correlation analyses were then conducted to investigate the associations between these neuroimaging indicators and the clinical features of PMS. RESULTS: The rsFC analysis revealed that PMS patients showed lower rsFC between the middle frontal gyrus (MFG) and the left thalamic medial posterior and ventral nuclei while higher rsFC between the insula and the left lateral posterior(LP) nuclei compared to HCs. Additionally, the findings demonstrated a correlation between the DRSP scores and rsFC, while the DRSP scores were positively correlated with (TNF-α) levels. Furthermore, the rsFC was found to be correlated with part of the inflammatory cytokines. CONCLUSION: The findings suggest that the observed functional connectivity alterations of the thalamus subregions are associated with the score of DRSP. This relationship appears to be largely dependent on the inflammation affecting the thalamic neural circuit, particularly the thalamic-MFG-insula network.