Revised Self-Monitoring Scale: A potential endpoint for frontotemporal dementia clinical trials

Gianina Toller, Kamalini Ranasinghe, Yann Cobigo, Adam Staffaroni, Brian Appleby, Danielle Brushaber, Giovanni Coppola, Bradford Dickerson, Kimiko Domoto-Reilly, Julie Fields, Jamie Fong, Leah Forsberg, Nupur Ghoshal, Neill Graff-Radford, Murray Grossman, Hilary Heuer, Gink Yuek Hsiung, Edward Huey, David Irwin, Kejal KantarciDaniel Kaufer, Diana Kerwin, David Knopman, John Kornak, Joel Kramer, Irene Litvan, Ian MacKenzie, Mario Mendez, Bruce Miller, Rosa Rademakers, Eliana Ramos, Katya Rascovsky, Erik Roberson, Jeremy Syrjanen, Carmela Tartaglia, Sandra Weintraub, Brad Boeve, Adam Boxer, Howard Rosen, Katherine Rankin

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


ObjectiveTo investigate whether the Revised Self-Monitoring Scale (RSMS), an informant measure of socioemotional sensitivity, is a potential clinical endpoint for treatment trials for patients with behavioral variant frontotemporal dementia (bvFTD).MethodsWe investigated whether RSMS informant ratings reflected disease severity in 475 participants (71 bvFTD mutation+, 154 bvFTD mutation-, 12 behavioral mild cognitive impairment [MCI] mutation+, 98 asymptomatic mutation+, 140 asymptomatic mutation-). In a subset of 62 patients (20 bvFTD mutation+, 35 bvFTD mutation-, 7 MCI mutation+) who had at least 2 time points of T1-weighted images available on the same 3T scanner, we examined longitudinal changes in RSMS score over time and its correspondence to progressive gray matter atrophy.ResultsRSMS score showed a similar pattern in mutation carriers and noncarriers, with significant drops at each stage of progression from asymptomatic to very mild, mild, moderate, and severe disease (F4,48 = 140.10, p < 0.001) and a significant slope of decline over time in patients with bvFTD (p = 0.004, 95% confidence interval [CI] -1.90 to -0.23). More rapid declines on the RSMS corresponded to faster gray matter atrophy predominantly in the salience network (SN), and RSMS score progression best predicted thalamic volume in very mild and mild disease stages of bvFTD. Higher RSMS score predicted more caregiver burden (p < 0.001, 95% CI -0.30 to -0.11).ConclusionsThe RSMS is sensitive to progression of both socioemotional symptoms and SN atrophy in patients with bvFTD and corresponds directly to caregiver burden. The RSMS may be useful in both neurologic practice and clinical trials aiming to treat behavioral symptoms of patients with bvFTD.

Original languageEnglish (US)
Pages (from-to)E2384-E2395
Issue number22
StatePublished - Jun 2 2020

ASJC Scopus subject areas

  • Clinical Neurology


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