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Editors' note: DBS of the PSA and the VIM in essential tremor: A randomized, double-blind, crossover trial

In “DBS of the PSA and the VIM in essential tremor: A randomized, double-blind, crossover trial,” Barbe et al. compared deep brain stimulation (DBS) of the posterior subthalamic area (PSA) to DBS of the ventral intermediate nucleus of the thalamus (VIM) in patients with essential tremor (ET). They found that PSA-DBS is at least equally effective as, but possibly more efficient than, VIM-DBS and that there are no notable differences in side effects between stimulation at the 2 sites. Dr. Sidiropoulos describes the study as “elegant,” but notes the following concerns: (1) differences in spacing of the leads may have affected activation of the intended targets; (2) the type of lead used should have been provided, particularly because—in contrast to Boston Scientific leads—Medtronic leads have only a single current source; (3) lower pulse widths should have been explored with the Boston Scientific leads; (4) the rate of intracerebral hemorrhage (2/13 patients) is concerning and may be accounted for by technique limitations.