The Neurostimulation Appropriateness Consensus Committee (NACC)®: Recommendations for the Mitigation of Complications of Neurostimulation

Timothy R. Deer, Marc A. Russo, Dawood Sayed, Jason E. Pope, Jay S. Grider, Jonathan M. Hagedorn, Steven M. Falowski, Adnan Al-Kaisy, Konstantin V. Slavin, Sean Li, Lawrence R. Poree, Sam Eldabe, Kaare Meier, Tim J. Lamer, Julie G. Pilitsis, Jose De Andrés, Christophe Perruchoud, Alexios G. Carayannopoulos, Susan M. Moeschler, Amir HadannyEric Lee, Vishal P. Varshney, Mehul J. Desai, Peter Pahapill, J. Osborn, Stana Bojanic, Ajay Antony, Fabian Piedimonte, Salim M. Hayek, Robert M. Levy

Research output: Contribution to journalReview articlepeer-review


Introduction: The International Neuromodulation Society convened a multispecialty group of physicians based on expertise and international representation to establish evidence-based guidance on the mitigation of neuromodulation complications. This Neurostimulation Appropriateness Consensus Committee (NACC)® project intends to update evidence-based guidance and offer expert opinion that will improve efficacy and safety. Materials and Methods: Authors were chosen on the basis of their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature. Section leaders supervised literature searches of MEDLINE, BioMed Central, Current Contents Connect, Embase, International Pharmaceutical Abstracts, Web of Science, Google Scholar, and PubMed from 2017 (when NACC last published guidelines) to October 2023. Identified studies were graded using the United States Preventive Services Task Force criteria for evidence and certainty of net benefit. Recommendations are based on the strength of evidence or consensus when evidence was scant. Results: The NACC examined the published literature and established evidence- and consensus-based recommendations to guide best practices. Additional guidance will occur as new evidence is developed in future iterations of this process. Conclusions: The NACC recommends best practices regarding the mitigation of complications associated with neurostimulation to improve safety and efficacy. The evidence- and consensus-based recommendations should be used as a guide to assist decision-making when clinically appropriate.

Original languageEnglish
Early online date13 Jun 2024
StateE-pub ahead of print - 13 Jun 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 International Neuromodulation Society


  • Best practices
  • consensus
  • neuromodulation
  • neurostimulation
  • spinal cord stimulation


Dive into the research topics of 'The Neurostimulation Appropriateness Consensus Committee (NACC)®: Recommendations for the Mitigation of Complications of Neurostimulation'. Together they form a unique fingerprint.

Cite this