The posterior subthalamic area (PSA) can be preferable to the traditional thalamic ventral intermediate nucleus (VIM) as a target for deep brain stimulation (DBS), a potent treatment for tremor that is insufficiently improved by medication alone.
Why this matters
Although DBS of the VIM is an established alternative to thalamotomy, tremor control has been shown to decrease over time in a proportion of patients.
DBS targeting the posterior subthalamic area (PSA-DBS) may provide superior tremor suppression. This potentially leads to other considerations for tremor surgery, e.g. use of modern neuroimaging techniques including tractography to refine the definition of the PSA target.