A new technique combining surface-based cortical myelin maps with Z-score methodology is developed to identify foci of cortical demyelination in patients with multiple sclerosis. The technique is found to discriminate (p=0.002) patients with MS (n=19) from patients with migraine (n=10), who often present with similar symptoms and white matter imaging findings. Regions of unusually low myelin content may correspond to lesions visible on the source T1-weighted and FLAIR images, but in other cases may be occult on either individual scan. The technique is clinically applicable, requiring only 3D T1 and FLAIR acquisitions that are already the standard of care in clinical neuroimaging.
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