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Revised Self-Monitoring Scale: A potential endpoint for frontotemporal dementia clinical trials
Gianina Toller1, Kamalini Ranasinghe1, Yann Cobigo1
1From the Department of Neurology (G.T., K.R., Y.C., A.S., J. Fong, H.H., J.K., J.K., B.M., A.B., H.R., K.R.), Memory and Aging Center, University of California, San Francisco; Case Western Reserve University (B.A.), Cleveland, OH; Mayo Clinic (D.B., J. Fields, L.F., N.G.-R., K.K., D. Knopman, J.S., B.B.), Rochester, MN; University of California (G.C., M.M., E.R.), Los Angeles; Department of Neurology (B.D.), Massachusetts General Hospital, Harvard Medical School, Boston; University of Washington (K.D.-R.), Seattle; Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.I., K.R.), Philadelphia; University of British Columbia (G.-Y.H., I.M.), Vancouver, Canada; Columbia University (E.H.), New York, NY; University of North Carolina (D. Kaufer), Chapel Hill; University of Texas Southwestern (D. Kerwin), Dallas; Department of Neuroscience (I.L.), Parkinson and Other Movement Disorder Center, University of California, San Diego; Mayo Clinic (R.R.), Jacksonville, FL; University of Alabama at Birmingham (E.R.); University of Toronto (C.T.), Ontario, Canada; and Mesulam Center for Cognitive Neurology and Alzheimer's Disease (S.W.), Northwestern University, Chicago, IL.
The Revised Self-Monitoring Scale (RSMS) effectively tracks behavioral variant frontotemporal dementia (bvFTD) progression and caregiver burden. This informant measure shows promise as a clinical endpoint for bvFTD treatment trials.
Area of Science:
- Neuroscience
- Clinical Neurology
- Psychometrics
Background:
- Behavioral variant frontotemporal dementia (bvFTD) is characterized by progressive socioemotional and behavioral changes.
- Identifying reliable clinical endpoints is crucial for evaluating therapeutic interventions in bvFTD.
- The Revised Self-Monitoring Scale (RSMS) is an informant-based measure assessing socioemotional sensitivity.
Purpose of the Study:
- To determine if the RSMS can serve as a clinical endpoint in treatment trials for bvFTD.
- To investigate the correlation between RSMS scores and disease severity in bvFTD.
- To examine the relationship between RSMS changes and neuroimaging markers of disease progression.
Main Methods:
- Assessed RSMS informant ratings in 475 participants, including bvFTD patients, controls, and those with mild cognitive impairment.
- Analyzed longitudinal changes in RSMS scores and T1-weighted MRI scans in a subset of 62 patients.
- Correlated RSMS scores with gray matter atrophy, particularly within the salience network (SN), and caregiver burden.
Main Results:
- RSMS scores significantly declined across all stages of bvFTD progression, from asymptomatic to severe.
- Longitudinal RSMS decline in bvFTD patients correlated with faster gray matter atrophy in the SN.
- Higher RSMS scores were associated with increased caregiver burden.
Conclusions:
- The RSMS is a sensitive measure of socioemotional symptom progression and SN atrophy in bvFTD.
- RSMS scores directly reflect caregiver burden in bvFTD.
- The RSMS holds potential utility for clinical practice and as a clinical endpoint in bvFTD treatment trials.
