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IntroductionWrist rigidity, conventionally qualitatively assessed by clinicians, is an important feature for the success of the deep brain stimulation of subthalamic nucleus (STN-DBS) surgery in patients with Parkinson's disease (PD). To tackle this subjectivity, our group designed and implemented a wearable device with an embedded sensor, the iHandU system (inSignals Neurotech), to quantify the rigidity in real time, supporting the clinical decision-making during STN-DBS.Methodology This study aimed to evaluate the clinical benefit of using the iHandU device for real-time rigidity quantification during STN-DBS surgery in patients with advanced idiopathic PD. For this purpose, we conducted a retrospective cohort study involving 81 patients with advanced PD undergoing STN-DBS in Movement Diseases and Functional Surgery Unit of the Centro Hospitalar e Universitário São João, Porto, Portugal,, comparing 40 patients assessed intraoperatively with the iHandU device to 41 patients assessed by manual methods. Clinical outcomes (motor scores, stimulation parameters, and medication dosage) were compared at multiple time points over a 12-month follow-up.ResultsWe found that the iHandU group showed significantly higher improvement in motor symptoms with reduced ON/OFF fluctuations and dyskinesias. These gains were obtained with less stimulation current, which reduced the occurrence of side effects, such as speech impairment. Moreover, the iHandU group did not show any significantly worse parameters, although sleep disturbances were more frequent (but not statistically significant) than in the control group.ConclusionsThe use of iHandU device during STN-DBS was associated with better clinical benefits, namely, by providing improved motor benefits, fewer dyskinesias, and fewer cases of speech disturbance, among other less significant benefits. The use of PD symptom measurement instead of qualitative assessment is probably associated with better clinical outcomes and should be used more frequently in symptom evaluation.
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