A Low-Cost, Open-Source Wireless Platform for Real-Time Tremor Monitoring in Parkinson's Disease.

We present a low-cost, open-source, wireless hardware platform dedicated to real-time tremor monitoring in Parkinson's disease (PD). The system is built on the ESP32-C6 microcontroller integrated with a 3-axis accelerometer and tilt sensor and employs ESP-NOW for wireless communication and multi-device synchronization. It supports up to five synchronized accelerometer nodes for assessing tremor and postural changes at the upper and lower limbs, as well as the jaw or chest. In this study, we demonstrate its application for intraoperative tracking of resting tremor and voluntary hand movements during brain stimulation (DBS) surgery, synchronized with neural recordings, while providing real-time feedback to the clinical team. Benchmarking tests confirmed sub-25 ms latency and robust synchronization between accelerometer nodes, underscoring its potential as a reliable tool for objective, real-time tremor quantification in both surgical and postoperative settings.