Brooke Hamilton has developed some of his own extensions to Presenter First and a cool-looking visual modeling tool to match. We at Atomic have not put it to use yet (none of us is using Visual Studio 2008) but it sure looks snazzy.
The tool and its source code are hosted on CodePlex: A Modeling Tool for the Presenter First Pattern
Also linked from that page is a bit of explanation regarding Brooke’s take on PF, setting it up for DSL use. I have not made use of this derivation of Presenter First (I tend to use my Presenters as the place where I describe my features—the one part of my application that cannot be auto-generated) but Brooke’s tool and approach have been working well for him, and as he says, “it’s a lot of fun, too.” Give it a read.