Spinal Cord (2020) 58:35–42 https://doi.org/10.1038/s41393-019-0338-5 ARTICLE Utility of the Neuropathic Pain Symptom Inventory in people with spinal cord injury Marlon L. Wong 1,2 ● Loriann Fleming 1 ● Linda E. Robayo 1 ● Eva Widerström-Noga 1 Received: 9 June 2019 / Revised: 22 July 2019 / Accepted: 23 July 2019 / Published online: 20 August 2019 © The Author(s), under exclusive licence to International Spinal Cord Society 2019 Abstract Study design Cohort/psychometric study Objectives The primary objective was to determine the psychometric properties and the utility of the Neuropathic Pain Symptom Inventory (NPSI) in subgrouping people with moderate to severe neuropathic pain after spinal cord injury (SCI). Setting University-based laboratory in Miami, FL USA. Methods Seventy-two people with chronic SCI and neuropathic pain were included in this study. The NPSI, Numeric Rating Scale (NRS), Multidimensional Pain Inventory pain severity and perceived support subscales (MPI-PS and MPI-S, respectively), and the Coping Strategies Questionnaire were administered. The NPSI was administered twice, with a 2–4- week period between measurement sessions. Results The NPSI total score demonstrated good internal consistency with a Cronbach’s alpha of 0.70. The test–retest reliability (intraclass correlations) ranged from 0.65 to 0.73 for the NPSI subscores and 0.79 for the total NPSI score. Further, construct validity was supported by moderate and significant positive correlations with the pain intensity NRS and pain severity subscale of the MPI (MPI-PS) (r > 0.40). Cluster analysis of factor scores derived from NPSI subscales, NRS, and MPI-PS scores revealed three distinct subgroups: (1) low-moderate, (2) moderate, and (3) high pain symptom severity with mean NPSI sum scores of 7.1, 17.5, and 33.8, respectively. Conclusion The NPSI demonstrated good psychometric properties in people with neuropathic pain after SCI. Moreover, it has utility for establishing pain symptom phenotypes. Introduction Neuropathic pain is an underrecognized contributing factor to the burden and diminished quality of life for people with spinal cord injury (SCI) [1]. In fact, neuropathic pain affects a large proportion of people with SCI, with an estimated prevalence rate of 53% [2]. Because neuropathic pain is known to be more severe and resistant to treatment than other types of pain [3], detailed diagnosis and effective management of neuropathic pain after SCI is an important component of medical care and research aimed at optimiz- ing the quality of life in this population. However, currently there are no interventions that provide consistent and widespread benefit for neuropathic pain after SCI [4]. Thus, detailed diagnosis and characterization of neuropathic pain associated with SCI is required for developing more per- sonalized and effective pain management [4, 5]. The Neuropathic Pain Symptom Inventory (NPSI) is one of the most widely used tools for characterizing neuropathic pain symptom severity, and it has been validated in over 50 different languages [6, 7]. The NPSI is comprised of five subscales, each representing different dimensions of neuro- pathic pain: burning spontaneous pain (burning), pressing spontaneous pain (pressing), paroxysmal pain (paroxysmal), evoked pain (evoked), and paresthesia/dysesthesia. This factorial structure makes the NPSI well suited for * Marlon L. Wong mwong2@miami.edu 1 Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA 2 Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL, USA Supplementary information The online version of this article (https:// doi.org/10.1038/s41393-019-0338-5) contains supplementary material, which is available to authorized users.