Disclaimer: I'm aware that Targeted Attack is intended for ranged weapons- specifically firearms- by RAW.
I've been elbows deep in a character concept that might actually see the light of day, but in doing so I started looking at using a Garrote.
Garrotes are awesome because if you can eat the -5 penalty to hit the neck (and they are quite kind to suggest using an all-out attack for +4, meaning an overall -1 skill penalty), you have the enemy trying to escape at ST-5, or Judo/Wrestling at -3. Contests to strangle give you a +3 bonus to ST.
The ST bonus for you and the penalty for the enemy are fairly significant, especially since you contest with Garrote against the attempt to escape. It allows a low strength individual a fairly nice way of taking out higher strength enemies.
Now, weirdness ensues when you use Targeted Attack Neck (Garrote) to reduce the hit penalty to -2 (from -5).
Without Targeted Attack, assuming Garrote Skill 12:
12 (skill) +4 (all-out attack) -5 (neck) = 11 modified skill
With 4 points in Targeted Attack, assuming Garrote Skill 12:
12 (skill) + 4 (all-out attack) -2 (neck) = 14 modified skill.
With 4 points in the Targeted Attack Technique, the skill level of Garrote effectively increases by 3.
I think my big issue here is that Garrote is not a skill that works without targeting the neck. You don't attempt to Garrote limbs, you don't wrap rope around someone's torso, a Garrote goes around the enemy's neck, period. There seems to be little point enforcing a location penalty when you have no option but to target that particular location.
Garrote is now a DX/Average skill. Attacker rolls vs Garrote to get it around the victim's neck. No attack modifiers (All-out, Telegraphic, etc) are valid.
Benefits: Fewer modifiers to deal with, overall same skill levels, no possibility of improving it with a technique.