Clinical characteristics of patients with interstitial cystitis/bladder pain syndrome combined with migraine.

Objectives: Interstitial cystitis/bladder pain syndrome (IC/BPS) and migraine are both chronic pain syndromes with similarities in pathophysiology and clinical presentation. This study aims to investigate the clinical characteristics of IC/BPS patients with comorbid migraine.
Methods: A retrospective analysis was conducted on the clinical data of 303 IC/BPS patients treated at the Second and Third Affiliated Hospitals of Qiqihar Medical University from January 2019 to December 2023. Disease severity, bladder pain and/or headache intensity, anxiety, depression, sleep quality, somatic symptoms, and quality of life were assessed using the O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI), Numerical Rating Scale (NRS), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), Self-Rating Somatic Symptom Scale (SSS), and Visual Analogue Scales (VAS) for quality of life. Serum inflammatory cytokines [interleukin-1β (IL-1β), interleukin-6 (IL-6)] and pain mediators [prostaglandin E2 (PGE2), substance P (SP)] were measured using enzyme-linked immunosorbent assay (ELISA).
Results: Among the 303 IC/BPS patients, 87 (28.71%) had comorbid migraine. Compared to IC/BPS patients without migraine, those with migraine had a longer IC/BPS duration, higher ICSI scores, elevated bladder pain NRS, GAD-7, PHQ-9, PSQI, SSS, VAS scores for quality of life, and higher serum levels of IL-1β, IL-6, PGE2, and SP, along with fewer weekly exercise sessions (all P <0.05). Among the 87 IC/BPS patients with migraine, the 39 patients with severe IC/BPS had higher headache frequency, longer headache duration, and significantly higher headache NRS, bladder pain NRS, GAD-7, PSQI, SSS, VAS scores for quality of life, and serum levels of IL-1β, IL-6, PGE2, and SP compared to the 48 patients with mild-to-moderate IC/BPS (all P <0.05). In IC/BPS patients with migraine, ICSI scores were positively correlated with headache NRS ( r =2.072, P =0.032), headache frequency ( r =2.184, P =0.028), headache duration ( r =1.843, P =0.041), bladder pain NRS ( r =2.295, P =0.023), GAD-7 scores ( r =2.210, P =0.025), SSS scores ( r =3.159, P =0.009), and VAS scores for quality of life ( r =2.891, P =0.013) but not with PSQI scores ( r =1.515, P =0.070).
Conclusions: Patients with IC/BPS and comorbid migraine exhibit more severe clinical and psychological symptoms. The severity of IC/BPS symptoms is associated with migraine severity.