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Limitations of the MDS-UPDRS include subjectivity and rater-dependency, which may be overcome by accelerometry. This study focused on relating the MDS-UPDRS hand tremor scores to an objective scoring method with 3D-accelerometry. An accelerometric algorithm to measure and classify tremor of the hands according to MDS-UPDRS criteria is proposed. Sixty-four PD patients and 64 healthy controls (matched on sex and age) were included. Two raters assessed MDS-UPDRS tremor-criteria, while accelerometry was performed at the index finger. Measurements were executed in an off-medication state, after a washout period of at least 12\u00a0h. The 3D-acceleration data included amplitude and area-under-the-curve of power in the 4\u20137\u00a0Hz range. Agreement between MDS-UPDRS and accelerometric scores was analyzed with Cohen\u2019s kappa coefficient (\u03ba). The trends between tremor amplitude and MDS-UPDRS score were consistent with the logarithmic relationship reported in previous studies. Overall, the accelerometric scores showed a substantial agreement (&gt;\u200980.2%, \u03ba\u2009\u2265\u20090.732) with the tremor amplitude according to MDS-UPDRS ratings. Accelerometric constancy of rest tremor (CRT) measures correlated less with MDS-UPDRS scores (R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009&lt;\u20090.469, p\u2009&lt;\u20090.001) than the other tasks. Accelerometric test\u2013retest reliability was good to excellent (ICC\u2009\u2265\u20090.789, p\u2009&lt;\u20090.001). MDS-UPDRS tremor tests can be reliably  translated to objective accelerometric measurements. However, discrepancies were found between accelerometric CRT-measures and MDS-UPDRS ratings. Accelerometry could complement visual evaluations of tremor, aiming to reduce rater-variability of MDS-UPDRS measurements and allow for more objective monitoring of tremor in the clinical setting.\n                  <\/jats:p>","DOI":"10.1007\/s00702-026-03132-0","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T12:15:30Z","timestamp":1773231330000},"page":"1457-1469","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative quantification of MDS-UPDRS-III tremor measurements in patients with Parkinson\u2019s disease using accelerometry"],"prefix":"10.1007","volume":"133","author":[{"given":"Annemarie","family":"Smid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Willem J.","family":"Elting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teus","family":"van Laar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolien M.","family":"ten Kate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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