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halamotomy and pallidotomy in a single patient. The centrally located VIM offers a more efficient location for therapeutic lesioning compared to GPi pallidotomy in SDR matched cohort of patients. The impact on therapeutic lesioning with lower SDR may be greater for pallidotomy patients. As newer off-center targets are investigated, these findings can inform patient selection and treatment requirements for lesion production. The centrally located VIM offers a more efficient location for therapeutic lesioning compared to GPi pallidotomy in