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“Pioneering Electroceuticals™”
Developing Non-Invasive Therapeutics for the Brain
Investor Presentation / January 2015
Confidential Rio Grande NeurosciencesPage 2
Might “Electroceuticals™” just be
the next “old new” thing?
“Only at the end of the last
century did we learn that we
can exquisitely fine-tune
molecules and a whole new
area of medicine opened
up. We are at a similar
juncture with the use of
electrical impulses.“
Keith Famm
Vice President
GlaxoSmithKline
Confidential Rio Grande NeurosciencesPage 3
Rio Grande Neurosciences (RGN)
•  Addressing unmet clinical needs through non-invasive treatment of pathologies of
the central nervous system (CNS)
•  Developing, acquiring and licensing non-invasive brain stimulation (NIBS)
technologies for treating neurological conditions
•  Lead technology is “targeted Pulsed ElectroMagnetic Field” (tPEMF) therapy
•  Current world-wide licensee for all neurological applications; existing FDA
clearance for treating pain and swelling
•  RGN is currently elucidating the anti-neuroinflammatory properties of tPEMF
•  Distinguished Medical Advisory Board and Military Medical Advisory Council led
respectively by Mitchel Berger, MD, and Major General (ret.) Gale Pollock
•  Top academic neurosurgical and neurosciences collaborators
•  Accomplished private and public company management leading current PIPE
Financing and Reverse Merger
Confidential Rio Grande NeurosciencesPage 4
To acquire, license, and develop non-invasive therapeutic
technologies for the treatment of brain pathologies.
To become the first-to-market aggregator of established
and experimental technologies in the NIBS area and a
conduit through which promising but underdeveloped
technologies can be investigated, commercialized, and
made available to clinical populations that will benefit
from their use.
Commercial Mission
Confidential Rio Grande NeurosciencesPage 5
Overview of Non-invasive Neurostimulation (NIBS)
Technologies
Induced Electrical Fields:
•  tPEMF; Transcranial magnetic stimulation (TMS); pulse external
magnetic fields to induce electrical fields (outside the body)
Direct Current and Capacitively-Coupled Electrical Fields:
•  Non-invasive stimulators: cranial electrical stimulation, transcranial
direct current stimulation, etc. (on the body)
•  FDA cleared/approved: Depression, Anxiety, Insomnia (CES)
•  No clearance (transcranial direct current simulation)
Other NIBS Modalities:
•  Low-Level Laser Therapy (LLLT), Ultrasound (US), Extremely-Low
Frequency Electromagnetic Fields (ELF-EMF)
Confidential Rio Grande NeurosciencesPage 6
Cranial electrical stimulation
(Anxiety, Depression,
Insomnia)
tDCS (Iontophoresis)
~ 50 trials
Trigeminal
Nerve
Stimulation
Low-intensity
rTMS
LLLT
Examples of NIBS technologies
Confidential Rio Grande NeurosciencesPage 7
“TheraCap™” study device for
sports concussion clinical trials
(therapy embedded in cap)
tPEMF: current FDA-cleared
disposable clinical treatment
unit
RGN’s proprietary tPEMF Technology
Confidential Rio Grande NeurosciencesPage 8
RGN’s first target: Traumatic Brain Injury (TBI)
•  1.8+ million cases present in US hospitals
annually
•  Up to an additional 3 million go
undiagnosed
•  Majority are mild TBI: concussions
!  At least 400,000 annually in youth
sports
!  Over 250,000 in the past decade in
the military
•  Over 5 million Americans are living with
permanent disability due to brain injury
•  Treatments currently available: none
Confidential Rio Grande NeurosciencesPage 9
mTBI - Primary and Secondary Injury
•  Primary injury – initial insult (e.g. hit to the head) causes a
“concussion” (symptoms include dizziness, loss of consciousness, fogginess,
etc.)
•  Secondary injury – neuroinflammation and its resulting chronic damage, reduced
blood flow, edema and neuronal death
•  Inflammatory response produces further symptoms that can lead to long-term
neurodegenerative pathologies
Confidential Rio Grande NeurosciencesPage 10
Significant barriers to treating mTBI
Drugs:
•  Fundamental challenge of pharmaceutical delivery across the blood-
brain barrier (BBB)
•  Unattractive side effect profiles, toxicity problems
•  Numerous failed clinical trials for stroke, TBI, etc.
Devices:
•  Various NIBS therapeutics, hyperbaric oxygen, cooling technologies,
near infrared light therapy are all inhibited by various combinations of:
•  lack of effectiveness data
•  lack of MOA understanding
•  lack of resources
•  lack of experienced management teams
tPEMF has clinically relevant bioeffects & is unimpeded by these barriers
Confidential Rio Grande NeurosciencesPage 11
•  Reduced microglial proliferation and activation
•  Reduced inflammatory (e.g., IL-1β) and apoptotic (TNF family)
cytokines and gene expression
•  Increased anti-inflammatory (e.g., IL-10 and IL-11) cytokine gene
expression
•  Increased cyclic GMP and AMP production
•  Improved blood vessel dilation and integrity
•  Reduced capillary shunting
•  Increased tissue perfusion and tissue oxygenation
Demonstrated Clinically Relevant tPEMF Effects in
Neurological Models
Confidential Rio Grande NeurosciencesPage 12
•  Improved blood brain barrier function and repair
•  Increased synaptic transmission and long-term potentiation (i.e.,
synaptic plasticity)
•  Improved neuronal mitochondrial efficiency
•  Enhanced neuritogenesis and growth
•  Promoted axonal growth and neuronal survival in the presence of
inflammatory insults
•  Provided neuroprotection in ischemic/metabolic injury
•  Potential for prophylactic applications (heat shock protein
mechanism)
Page 12
Demonstrated Clinically Relevant tPEMF Effects in
Neurological Models (con’t)
Confidential Rio Grande NeurosciencesPage 13
tPEMF rationale in mTBI
•  tPEMF is focused on treating mTBI Secondary Injury to alleviate
neuroinflammation and enhance blood flow, thereby reducing
neuropathology; RGN is evaluating these effects in both ongoing and
planned clinical trials
control PEMF
Reduced microglial activation with
tPEMF in brain injury
Reduced IL-1β
(inflammatory
biomarker in
concussed
animals treated
with PEMF)
Confidential Rio Grande NeurosciencesPage 14
Pathway to Commercialization for RGN’s tPEMF
Clinical Study
Timelines
Friday Night Lights Out
•  4Q ’14 – 3Q ‘15
Indication
EU Launch 4Q ’15 (OTC)
Pre-IDE Meeting 1H ’15
510(k) Filing 3Q ’15
FDA Clearance 2H ’16 (Rx)
Reducing Post Concussion
Syndrome
•  3Q ’15 –2Q ‘16
tPEMF’s Effect on Long-Term
Neurodegeneration and
Possible CTE
•  2Q ‘16 – 2Q ‘17
Regulatory Milestones
Treatment of Acute
Concussive Syndrome
Treatment of Chronic Post
Concussive Syndrome
Expand EU OTC Indication 2Q ‘16
510(k) Filing 2Q ‘16
FDA Clearance 4Q ’16 (Rx)
Treatment of
Neurodegeneration
associated with history of
concussions
Expand EU OTC Indication 3Q ‘17
510(k) Filing 3Q ‘17
FDA Clearance Q1 ‘18
Confidential Rio Grande NeurosciencesPage 15
•  Extend current studies using validated animal models of concussion and cell
culture models of both neuroinflammation and neuroprotection (Harvard,
University of New Mexico & Los Alamos National Labs)
•  biomarkers (including tau) and functional outcomes
•  dosimetry, signal optimization, and mechanisms of action
•  Basic science work in standard blast injury animal models (Boston
University)
•  biomarkers (including tau) and functional outcomes
•  Evaluate tPEMF’s potential in synaptic development/transmission and
plasticity models including learning and memory (Buck Institute & UCSF’s
Gazzaley Laboratory)
•  Evaluate tPEMF in EAE model of multiple sclerosis focusing on blood brain
barrier permeability and neuroinflammation (UCSF)
Ongoing Basic Science Research Program
Confidential Rio Grande NeurosciencesPage 16
•  “Friday Nights Lights Out” (UT Southwestern, double-blind RCT)
•  Post Concussion Syndrome Study (Harvard, double-blind RCT)
•  Integration of tPEMF therapy into Harvard’s Neuromodulation Lab
pantheon of modalities (case study collection)
•  initial trial on healthy controls focusing on qEEG effects
•  Expansion of clinical trial in severely injured trauma and stroke patients
to include comprehensive biomarker analysis directly from ventricular
cerebrospinal fluid (UNM)
•  Evaluation of tPEMF in post-concussion patients through Defense
Center of Excellence invitation
•  Proposed clinical TBI pilot through DVBIC at Brooke Army Medical
Center
Ongoing and Planned Clinical Research Program
Confidential Rio Grande NeurosciencesPage 17
Principal Investigators
•  Hunt Batjer, MD, Professor & Chairman, Neurological Surgery, UT–
Southwestern; Co-Chair, NFL Head, Neck and Spine Medical Committee
•  Mark Goldberg, MD, Professor & Chairman, Neurology, UT-Southwestern;
founding Director, Washington University Hope Center for Neurological
Disorders
“Friday Night Lights Out” Study
Proposed NINDS (SBIR) Post Concussion Syndrome Study
•  Ross Zafonte, DO, Professor and Chairman, Department of Physical
Medicine & Rehabilitation, Harvard Medical School; Chief of Physical
Medicine & Rehabilitation, Spaulding Rehabilitation Hospital (MGH)
Confidential Rio Grande NeurosciencesPage 18
NIBS Market is Primed for Consolidation
•  Significantly increased prevalence of neurodegenerative disease (i.e.
Alzheimer’s, Parkinson’s, dementia) and brain injury worldwide
•  Dramatically heightened societal awareness of its devastating economic and
human consequences
•  Failure of pharmaceuticals to successfully address the burgeoning unmet
related medical needs
•  While many potentially exciting NIBS technologies exist, this market remains
immature, under-funded and highly fragmented
•  Most NIBS companies lack sufficient resources to meet critical scientific, clinical
and commercialization goals and stringent regulatory requirements
RGN’s team will utilize its collective expertise, experience,
relationships and public market presence to lead this
rationalization/consolidation by developing, acquiring and
licensing “best-of-breed” NIBS technologies and their supporting
software applications
Confidential Rio Grande NeurosciencesPage 19
Aggregation Opportunity
•  Sufficient evidence exists to support several NIBS technologies to
deliver stimulation where and when it is needed
•  Multiple biological and regulatory pathways to successfully treating
patients are being evaluated
•  Multiple single-technology companies are all attempting to bring NIBS
therapeutics to market but often:
•  Are undercapitalized
•  Lack sufficient basic science support
•  Have speculative or unknown “mechanisms of action” (MOA)
•  RGN is exploring the following NIBS technologies for acquisition:
Confidential Rio Grande NeurosciencesPage 20
tDCS
•  Low-level direct current
•  FDA-cleared as iontophoresis devices
•  Significant body of clinical literature
•  Can enhance as well as degrade cognitive abilities,
depending on how applied
•  Strong interest from military
•  Enhanced real-time cognitive abilities
•  Significant variation in effect across subjects
•  MOA not well-described
Confidential Rio Grande NeurosciencesPage 21
CES
•  Low-level alternating current
•  FDA-cleared for treating anxiety, depression and insomnia
•  Used in conjunction with counselling for treating PTSD
•  US military use
•  Significant body of clinical literature
•  MOA not well characterized
•  Where does energy go?
Confidential Rio Grande NeurosciencesPage 22
TMS
•  Direct descendent of ECT
•  Designed to trigger excitable membranes
•  High-power, low penetration
•  FDA-cleared for treating refractory
depression
•  MOA not well understood
•  Half-power TMS designed for home use
•  FDA-cleared to treat aura-related migraine at
onset
•  RCT support weak
•  FDA cleared on potential effectiveness and
safety
Confidential Rio Grande NeurosciencesPage 23
LLLT
•  FDA-cleared for multiple non-neuroscience
applications
•  MOA outlined: neuroprotective and anti-
inflammatory effects
•  Early trial failed Phase III clinical trial in
stroke
•  Subset appeared to benefit
•  Potential applications in cognition and
neurorehabilitation
Confidential Rio Grande NeurosciencesPage 24
Trigeminal Nerve Stimulation
•  Buccal spatially separated stimulation for improved
neuroplasticity
•  MOA not well-characterized
•  Placebo effect > 40%
•  Transdermal TNS cleared by FDA
for treating migraine
•  CE-marked for treating epilepsy
•  MOA not well characterized
Confidential Rio Grande NeurosciencesPage 25
Emerging NIBS
•  ELF-EMF
•  Magnetic field effects
•  Variable effects
•  Dependent on signal characteristics
•  Transcutaneous Vagal Nerve Stimulation
•  Auricular stimulation of vagal nerve
•  Treating epilepsy, depression
•  Transcranial ultrasound
•  Enhanced cognitive performance
•  DARPA prototype
Confidential Rio Grande NeurosciencesPage 26
•  Steven Gluckstern, EdD, MBA – Chairman & CEO
-  Chairman & CEO, Ivivi Health Sciences
-  Chairman, Zurich Scudder Investments
-  Expertise: Leadership, Entrepreneurship, Finance, Public Company Executive
Management
•  Stephen Juelsgaard, JD DVM – Board member
-  Former General Counsel – Genentech Inc.
-  Expertise: Leadership, Public Company Executive Management, Intellectual
Property Development, FDA
Board of Directors
Confidential Rio Grande NeurosciencesPage 27
•  Steven Gluckstern – Chairman & CEO
•  Sean Hagberg, PhD – Chief Strategist
-  Clinical Assistant Professor, Neurosurgery, UNM
-  Co-founder and Chief Science Officer, Ivivi Technologies
-  Expertise: Clinical Innovation and Adoption, Strategy, tPEMF Research and Development
•  Blake Gurfein, PhD – Chief Science Officer
-  Assistant Professor of Medicine, UCSF
-  NIH–funded Principal Investigator
-  Expertise: Neuroimmunology, CNS Pathology, Scientific Project Management
•  David Muehsam, PhD – Senior Biophysicist
-  Visual Institute of Developmental Arts & Sciences, Bologna, Italy
-  Expertise: Bioelectromagnetic Therapeutics, Biophysical Transduction Mechanisms, Mathematical
Modeling
•  Shamini Jain, PhD – Director of Technology Discovery
-  Founder and Executive Director, Consciousness and Healing Initiative
-  Assistant Professor, Psychiatry & Behavioral Medicine, UCSD
-  Expertise: Psychoneuroimmunology, Clinical Psychology, Program Management
•  Michael Weisend – Senior Scientist
-  Senior research Scientist, Wright State Research Institute
-  Associate Professor of Translational Neuroscience, Mind Research Institute
-  Expertise: Clinical Neurophysiology, Neurocognition, tDCS and other NIBS modalities
Executive Management Team
Confidential Rio Grande NeurosciencesPage 28
•  Mitchel Berger, MD, Medical Advisory Chair
-  Neurosurgery Chair, UCSF
-  Member of NFL Head, Neck, & Spine Medical Committee
-  Fmr. President, American Association of Neurological Surgeons
•  Adam Gazzaley, MD, PhD,
-  Professor Neurology, Physiology and Psychiatry, UCSF
-  Director, Neuroscience Imaging Center, UCSF
-  Director, Gazzaley Lab for Cognitive Neuroscience Research, UCSF
•  David Hovda, PhD
-  Director, UCLA Brain Injury Research Center, Professor of Neurosurgery, Biomedical Physics,
Molecular & Medical Pharmacology
-  Fmr. President, National Neurotrauma Society
•  Geoff Manley, MD, PhD
-  Professor and Vice Chair Neurosurgery, Co-Director Brain and Spinal Injury Center, UCSF
-  Chief of Neurosurgery, SF General Hospital
-  Principal Investigator: Transforming Research And Clinical Knowledge in TBI (“TRACK-TBI”,
multicenter $18.8 million, five year NINDS Grant)
•  Pratik Mukherjee, MD, PhD
-  Director, Center for Imaging of Neurological Diseases
-  Professor of Radiology, Biomedical Imaging and Bioengineering, UCSF
-  Principal Investigator TRACK-TBI
•  Howard Yonas, MD
-  Neurosurgery Chair, UNM
-  Director, UNM Cerebrovascular Center
-  Founder and Co-Director of the UPMC Stroke Institute
Medical Advisory Board
Confidential Rio Grande NeurosciencesPage 29
Military Medical Advisory Council
•  Gale Pollock CRNA, FACHE, FAAN, Chair
-  Fmr. Chief, Army Nurses Corp
-  Member of NFL Head, Neck, & Spine Medical Committee
-  Fmr. Acting Surgeon General, U.S. Army
-  Retired Major General, U.S. Army
•  James Ecklund, MD
-  Chairman, Department of Neurosciences Inova Fairfax Hospital
-  Fmr. Chairman, Neurosurgery Program - National Capital Consortium (includes Walter Reed
Army Medical Center, National Naval Medical Center and the Uniformed Services University)
-  Retired Colonel and trauma surgeon, U.S. Army
•  Kenneth Farmer, MD
-  Fmr. Chief, North Atlantic Regional Medical Command and Walter Reed Army Medical Center
-  Fmr. Deputy Surgeon General, U.S. Army
-  Fmr. Chief of Staff, U.S. Army Medical Command
-  Retired Major General, U.S. Army
•  John Holcomb, MD
-  Director, Center for Translational Injury Research, Vice Chair and Professor Department of
Surgery, University of Texas Houston
-  Fmr. Director, U.S. Army Institute of Surgical Research
-  Retired Colonel and trauma surgeon, U.S. Army
Confidential Rio Grande NeurosciencesPage 30
Special Advisors
Rio Grande Neurosciences
•  Arthur Pilla, PhD
-  Senior Scientific Advisor, Professor Emeritus Mt. Sinai Medical School, Columbia University
-  Inventor of tPEMF and bone growth stimulator
-  Co-founder EBI, Ivivi Technologies
•  Robert Cantu, MD
-  Clinical Professor of Neurosurgery, Boston University, Co-Director, Center for the Study of
Traumatic Encephalopathy, BU
-  Chairman, Department of Surgery, Chief Neurosurgery Service, Director, Service Sports Medicine
at Emerson Hospital (MGH)
•  Joseph C. Maroon, MD, FACS
-  Professor and Vice Chairman, Department of Neurological Surgery and Heindl Scholar in
Neuroscience, UPMC
-  Team neurosurgeon, Pittsburgh Steelers (since 1981)
•  Milton McColl, MD
-  Former NFL Player, San Francisco 49ers
-  Fmr. Venture Partner, New Leaf Ventures
-  Fmr. President, Neurovascular Div., Boston Scientific
•  Christopher Nowinski
-  Co-Founder and Executive Director, Sports Legacy Institute (SLI)
-  Co-Director, Center for the Study of Traumatic Encephalopathy; advisor, NFL Players Association,
Mackey-White Traumatic Brain Injury Committee
Confidential Rio Grande NeurosciencesPage 31
•  Accomplished and visionary management team
•  Addressing vast and unprecedented unmet medical need
•  Distinguished medical advisors and principal investigators
•  Significant IP portfolio and ongoing IP development
•  Substantial opportunity to acquire and/or license NIBS
technologies
•  “First-to-market” public vehicle for driving consolidation,
innovation and adoption of emerging NIBS therapeutics
RGN Summary
Appendix – Supporting science slides for tPemf/Theracap
Confidential Rio Grande NeurosciencesPage 32
Confidential Rio Grande NeurosciencesPage 33
Our PEMF device
•  Safe and well-tolerated in the periphery
•  Provides anti-inflammatory effects
•  Reduces edema and pain
•  Enhances blood flow
Large unmet need for TBI therapies
•  Hallmarks of TBI pathology are neuroinflammation, edema, reduced
blood flow, and neuronal death
•  Whereas drugs may not pass the blood brain barrier, PEMF is an
inductive therapy that can easily treat the CNS
CNS-PEMF Rationale
Confidential Rio Grande NeurosciencesPage 34
PEMF Effect on Post-op IL-1β
•  tPEMF technology has been demonstrated in two post-surgical
controlled trials to significantly reduce pain, swelling, pain medication
use and key inflammatory biomarker IL-1β
IL-1β levels 50-75% lower in treated patients; pain and pain
medication use reduced by 50% (left: n = 24; right: n = 32)
N=24 (12/12)
N=32(16/16)
Confidential Rio Grande NeurosciencesPage 35
tPEMF and Traumatic Brain Injury
Rio Grande Neurosciences
Rodents with concussion were treated
with SHAM or tPEMF for 6 hours
Neuroinflammation occurs after brain
injury and higher levels of the
inflammatory cytokine IL-1β are
associated with worsened pathology and
poor functional outcomes
(i.e., greater disability)
p ≤ 0.02
*
Rasouli et al. 2012
tPEMF treated animals had 5-fold less
IL-1β in the CSF 6 hours after
concussion compared to SHAM-treated
animals
Confidential Rio Grande NeurosciencesPage 36
tPEMF and Traumatic Brain Injury
Rio Grande Neurosciences
Rodents with a penetrating TBI treated with SHAM or tPEMF
tPEMF treated animals had 5-fold less IL-1β in the CSF 18 hours after
injury compared to SHAM control animals.
p ≤ 0.001
p ≤ 0.015
Rasouli et al. 2012
Confidential Rio Grande NeurosciencesPage 37
tPEMF Reduces Numbers of Activated Microglia
0
5 0
1 0 0
1 5 0
2 0 0
2 5 0
c o n t r o l L M E P E M F L M
+ PE
OX-42
+
microglia
*
0
5 0
1 0 0
1 5 0
2 0 0
2 5 0
c o n t r o l L M E P E M
OX-42
+
microglia
Rio Grande Neurosciences
Primary co-cultures of neurons and microglia
stimulated with LPS (inflammatory agent) for
24h followed by 30 min of tPEMF treatment
Microglia are resident immune cells in the
brain and activated microglia (OX-42+) are a
focal source of local inflammation
p < 0.05
Quantification demonstrated that there
were significantly fewer activated
microglia in tPEMF treated cultures,
evidence of anti-neuroinflammatory
effects
Confidential Rio Grande NeurosciencesPage 38
tPEMF Reduces Microglial Reactivity After Injury
control PEMF
Rio Grande Neurosciences
Neuroinflammation induced
in response to damage
caused by a penetrating
injury in rodent brain.
tPEMF applied twice daily for
one week.
Staining for OX-42+ activated
microglial
PEMF treated tissue (right)
exhibits visibly less
microglial activation
Confidential Rio Grande NeurosciencesPage 39
tPEMF Effects In High Intracranial Pressure (ICP) Model
Increased
Arteriole
Diameter
Increased
Tissue
Oxygenation
Rat model of high intracranial pressure
•  ICP raised to 30mmHG
•  Treated with PEMF for 30 minutes
•  Arteriole diameter was measured
using intravital 2-photon
microscopy
•  Tissue oxygenation quantitated
measuring NADH auto-
fluorescence
•  NADH is fluorescent and whereas
oxidized NAD+ is not
p < 0.05
p < 0.05
Confidential Rio Grande NeurosciencesPage 40
tPEMF Effects In High Intracranial Pressure (ICP) Model
Reduced
Microvascular
Shunting
*
Reduced
BBB
Permeability
Rat model of high intracranial pressure
•  Ratio of microvascular shunting to
capillary flow (nutritive blood flow)
was lower in PEMF treated animals
•  The amount of leakage of a
fluorescent agent from the CNS
vasculature into the brain parenchyma
was lower in PEMF treated animals
•  Suggesting improved blood-brain-
barrier function
p < 0.05
p < 0.05
Confidential Rio Grande NeurosciencesPage 41
tPEMF Effects in Sub-Acute Stroke Model
Sub-acute stroke study demonstrated substantial effects of tPEMF on
gene expression in animals in later stage stroke recovery (7 days)
•  Increased anti-inflammatory gene expression
•  Decreased inflammatory & apoptotic gene expressions
PEMF BID for 15 minutes
Starting 3 days post-stroke
for 7 days
Confidential Rio Grande NeurosciencesPage 42
Neuroprotective Effects of tPEMF
Neuronal Insult Model
•  Primary cortical neurons exposed to
oxygen and glucose deprivation (OGD)
for 1, 2, or 3 hours
•  PEMF treatment for 30 minutes at the
onset of OGD
•  Cells stained for TUNEL, a marker of
DNA fragmentation and apoptosis
•  50% fewer apoptotic cells found in
PEMF-treated compared with
untreated cultures
Confidential Rio Grande NeurosciencesPage 43
PEMF effects on Long-Term Potentiation
PEMF treatment in a hippocampal
slice model significantly increased
synaptic transmission, which is
associated with long-term
potentiation (LTP), a process
required
for learning and memory.
Confidential Rio Grande NeurosciencesPage 44
Effects of tPEMF on EAE
0
1
2
D0 D1 D2 D3 D4 D5 D6 D7 D8 D9 D10 D11 D12 D13 D14 D15 D16 D17 D18 D19 D20 D21 D22 D23 D24 D25 D26 D27 D28 D29
Day
MeanEAEscore
Control
PEMF
Sham
PI: Sergio Baranzini (UCSF)
EAE: Inflammatory autoimmune model of multiple sclerosis
Scoring: 0 (healthy) – 5 (moribund)
PEMF or Sham treatment of mice with EAE (n = 10 per group)
Treated 15 minutes twice per day
Repeated Measures ANOVA, p = 0.077
Treatment * Time
Confidential Rio Grande NeurosciencesPage 45
Ongoing Research Collaborations
Basic Science Studies
Michael Whalen, M.D. Ph.D. – Harvard University
•  Effects of PEMF on rodent concussion and learning.
Sergio Baranzini, Ph.D. – University of California San Francisco
•  Effects of PEMF on EAE, an animal model of multiple sclerosis.
Lee Goldstein M.D. Ph.D. – Boston University
•  Use of PEMF to prevent CTE pathology and tau deposition.
Pejmun Haghighi, Ph.D. – Buck Institute for Research on Aging
•  Effects of PEMF on synaptic function
Kiran Bhaskar Ph.D. – University of New Mexico
•  Anti-neuroinflammatory effects on microglia and astrocytes
•  Genomics interrogation of PEMF effects on inflammation
Confidential Rio Grande NeurosciencesPage 46
Ongoing Research Collaborations
Clinical Studies
Hunt Batjer, M.D. – UT Southwestern (December 2014)
•  Randomized Controlled Trial – PEMF treatment of sports concussion
•  High school and college football players
•  Focus: latency of symptom resolution and return to play
Adam Gazzaley, M.D. Ph.D. – UCSF (Ongoing)
•  Effects of PEMF on cognitive function and multitasking performance
Leon Morales-Quezada, M.D. – Harvard University
•  Effects of PEMF on EEG activity
Howard Yonas, M.D. – University of New Mexico
•  PEMF treatment of severe traumatic brain injury
Confidential Rio Grande NeurosciencesPage 47
Pending Grant Support
National Institutes of Health
National Institute of Neurological Disorders and Stroke
•  STTR Fast Track Phase I/II
•  Effects of PEMF as a treatment for post-concussion syndrome.
•  Co-PI – Ross Zafonte PhD (Harvard Medical School)
•  Submission: December 5th, 2014

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RGN investor presentation January 2015

  • 1. “Pioneering Electroceuticals™” Developing Non-Invasive Therapeutics for the Brain Investor Presentation / January 2015
  • 2. Confidential Rio Grande NeurosciencesPage 2 Might “Electroceuticals™” just be the next “old new” thing? “Only at the end of the last century did we learn that we can exquisitely fine-tune molecules and a whole new area of medicine opened up. We are at a similar juncture with the use of electrical impulses.“ Keith Famm Vice President GlaxoSmithKline
  • 3. Confidential Rio Grande NeurosciencesPage 3 Rio Grande Neurosciences (RGN) •  Addressing unmet clinical needs through non-invasive treatment of pathologies of the central nervous system (CNS) •  Developing, acquiring and licensing non-invasive brain stimulation (NIBS) technologies for treating neurological conditions •  Lead technology is “targeted Pulsed ElectroMagnetic Field” (tPEMF) therapy •  Current world-wide licensee for all neurological applications; existing FDA clearance for treating pain and swelling •  RGN is currently elucidating the anti-neuroinflammatory properties of tPEMF •  Distinguished Medical Advisory Board and Military Medical Advisory Council led respectively by Mitchel Berger, MD, and Major General (ret.) Gale Pollock •  Top academic neurosurgical and neurosciences collaborators •  Accomplished private and public company management leading current PIPE Financing and Reverse Merger
  • 4. Confidential Rio Grande NeurosciencesPage 4 To acquire, license, and develop non-invasive therapeutic technologies for the treatment of brain pathologies. To become the first-to-market aggregator of established and experimental technologies in the NIBS area and a conduit through which promising but underdeveloped technologies can be investigated, commercialized, and made available to clinical populations that will benefit from their use. Commercial Mission
  • 5. Confidential Rio Grande NeurosciencesPage 5 Overview of Non-invasive Neurostimulation (NIBS) Technologies Induced Electrical Fields: •  tPEMF; Transcranial magnetic stimulation (TMS); pulse external magnetic fields to induce electrical fields (outside the body) Direct Current and Capacitively-Coupled Electrical Fields: •  Non-invasive stimulators: cranial electrical stimulation, transcranial direct current stimulation, etc. (on the body) •  FDA cleared/approved: Depression, Anxiety, Insomnia (CES) •  No clearance (transcranial direct current simulation) Other NIBS Modalities: •  Low-Level Laser Therapy (LLLT), Ultrasound (US), Extremely-Low Frequency Electromagnetic Fields (ELF-EMF)
  • 6. Confidential Rio Grande NeurosciencesPage 6 Cranial electrical stimulation (Anxiety, Depression, Insomnia) tDCS (Iontophoresis) ~ 50 trials Trigeminal Nerve Stimulation Low-intensity rTMS LLLT Examples of NIBS technologies
  • 7. Confidential Rio Grande NeurosciencesPage 7 “TheraCap™” study device for sports concussion clinical trials (therapy embedded in cap) tPEMF: current FDA-cleared disposable clinical treatment unit RGN’s proprietary tPEMF Technology
  • 8. Confidential Rio Grande NeurosciencesPage 8 RGN’s first target: Traumatic Brain Injury (TBI) •  1.8+ million cases present in US hospitals annually •  Up to an additional 3 million go undiagnosed •  Majority are mild TBI: concussions !  At least 400,000 annually in youth sports !  Over 250,000 in the past decade in the military •  Over 5 million Americans are living with permanent disability due to brain injury •  Treatments currently available: none
  • 9. Confidential Rio Grande NeurosciencesPage 9 mTBI - Primary and Secondary Injury •  Primary injury – initial insult (e.g. hit to the head) causes a “concussion” (symptoms include dizziness, loss of consciousness, fogginess, etc.) •  Secondary injury – neuroinflammation and its resulting chronic damage, reduced blood flow, edema and neuronal death •  Inflammatory response produces further symptoms that can lead to long-term neurodegenerative pathologies
  • 10. Confidential Rio Grande NeurosciencesPage 10 Significant barriers to treating mTBI Drugs: •  Fundamental challenge of pharmaceutical delivery across the blood- brain barrier (BBB) •  Unattractive side effect profiles, toxicity problems •  Numerous failed clinical trials for stroke, TBI, etc. Devices: •  Various NIBS therapeutics, hyperbaric oxygen, cooling technologies, near infrared light therapy are all inhibited by various combinations of: •  lack of effectiveness data •  lack of MOA understanding •  lack of resources •  lack of experienced management teams tPEMF has clinically relevant bioeffects & is unimpeded by these barriers
  • 11. Confidential Rio Grande NeurosciencesPage 11 •  Reduced microglial proliferation and activation •  Reduced inflammatory (e.g., IL-1β) and apoptotic (TNF family) cytokines and gene expression •  Increased anti-inflammatory (e.g., IL-10 and IL-11) cytokine gene expression •  Increased cyclic GMP and AMP production •  Improved blood vessel dilation and integrity •  Reduced capillary shunting •  Increased tissue perfusion and tissue oxygenation Demonstrated Clinically Relevant tPEMF Effects in Neurological Models
  • 12. Confidential Rio Grande NeurosciencesPage 12 •  Improved blood brain barrier function and repair •  Increased synaptic transmission and long-term potentiation (i.e., synaptic plasticity) •  Improved neuronal mitochondrial efficiency •  Enhanced neuritogenesis and growth •  Promoted axonal growth and neuronal survival in the presence of inflammatory insults •  Provided neuroprotection in ischemic/metabolic injury •  Potential for prophylactic applications (heat shock protein mechanism) Page 12 Demonstrated Clinically Relevant tPEMF Effects in Neurological Models (con’t)
  • 13. Confidential Rio Grande NeurosciencesPage 13 tPEMF rationale in mTBI •  tPEMF is focused on treating mTBI Secondary Injury to alleviate neuroinflammation and enhance blood flow, thereby reducing neuropathology; RGN is evaluating these effects in both ongoing and planned clinical trials control PEMF Reduced microglial activation with tPEMF in brain injury Reduced IL-1β (inflammatory biomarker in concussed animals treated with PEMF)
  • 14. Confidential Rio Grande NeurosciencesPage 14 Pathway to Commercialization for RGN’s tPEMF Clinical Study Timelines Friday Night Lights Out •  4Q ’14 – 3Q ‘15 Indication EU Launch 4Q ’15 (OTC) Pre-IDE Meeting 1H ’15 510(k) Filing 3Q ’15 FDA Clearance 2H ’16 (Rx) Reducing Post Concussion Syndrome •  3Q ’15 –2Q ‘16 tPEMF’s Effect on Long-Term Neurodegeneration and Possible CTE •  2Q ‘16 – 2Q ‘17 Regulatory Milestones Treatment of Acute Concussive Syndrome Treatment of Chronic Post Concussive Syndrome Expand EU OTC Indication 2Q ‘16 510(k) Filing 2Q ‘16 FDA Clearance 4Q ’16 (Rx) Treatment of Neurodegeneration associated with history of concussions Expand EU OTC Indication 3Q ‘17 510(k) Filing 3Q ‘17 FDA Clearance Q1 ‘18
  • 15. Confidential Rio Grande NeurosciencesPage 15 •  Extend current studies using validated animal models of concussion and cell culture models of both neuroinflammation and neuroprotection (Harvard, University of New Mexico & Los Alamos National Labs) •  biomarkers (including tau) and functional outcomes •  dosimetry, signal optimization, and mechanisms of action •  Basic science work in standard blast injury animal models (Boston University) •  biomarkers (including tau) and functional outcomes •  Evaluate tPEMF’s potential in synaptic development/transmission and plasticity models including learning and memory (Buck Institute & UCSF’s Gazzaley Laboratory) •  Evaluate tPEMF in EAE model of multiple sclerosis focusing on blood brain barrier permeability and neuroinflammation (UCSF) Ongoing Basic Science Research Program
  • 16. Confidential Rio Grande NeurosciencesPage 16 •  “Friday Nights Lights Out” (UT Southwestern, double-blind RCT) •  Post Concussion Syndrome Study (Harvard, double-blind RCT) •  Integration of tPEMF therapy into Harvard’s Neuromodulation Lab pantheon of modalities (case study collection) •  initial trial on healthy controls focusing on qEEG effects •  Expansion of clinical trial in severely injured trauma and stroke patients to include comprehensive biomarker analysis directly from ventricular cerebrospinal fluid (UNM) •  Evaluation of tPEMF in post-concussion patients through Defense Center of Excellence invitation •  Proposed clinical TBI pilot through DVBIC at Brooke Army Medical Center Ongoing and Planned Clinical Research Program
  • 17. Confidential Rio Grande NeurosciencesPage 17 Principal Investigators •  Hunt Batjer, MD, Professor & Chairman, Neurological Surgery, UT– Southwestern; Co-Chair, NFL Head, Neck and Spine Medical Committee •  Mark Goldberg, MD, Professor & Chairman, Neurology, UT-Southwestern; founding Director, Washington University Hope Center for Neurological Disorders “Friday Night Lights Out” Study Proposed NINDS (SBIR) Post Concussion Syndrome Study •  Ross Zafonte, DO, Professor and Chairman, Department of Physical Medicine & Rehabilitation, Harvard Medical School; Chief of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital (MGH)
  • 18. Confidential Rio Grande NeurosciencesPage 18 NIBS Market is Primed for Consolidation •  Significantly increased prevalence of neurodegenerative disease (i.e. Alzheimer’s, Parkinson’s, dementia) and brain injury worldwide •  Dramatically heightened societal awareness of its devastating economic and human consequences •  Failure of pharmaceuticals to successfully address the burgeoning unmet related medical needs •  While many potentially exciting NIBS technologies exist, this market remains immature, under-funded and highly fragmented •  Most NIBS companies lack sufficient resources to meet critical scientific, clinical and commercialization goals and stringent regulatory requirements RGN’s team will utilize its collective expertise, experience, relationships and public market presence to lead this rationalization/consolidation by developing, acquiring and licensing “best-of-breed” NIBS technologies and their supporting software applications
  • 19. Confidential Rio Grande NeurosciencesPage 19 Aggregation Opportunity •  Sufficient evidence exists to support several NIBS technologies to deliver stimulation where and when it is needed •  Multiple biological and regulatory pathways to successfully treating patients are being evaluated •  Multiple single-technology companies are all attempting to bring NIBS therapeutics to market but often: •  Are undercapitalized •  Lack sufficient basic science support •  Have speculative or unknown “mechanisms of action” (MOA) •  RGN is exploring the following NIBS technologies for acquisition:
  • 20. Confidential Rio Grande NeurosciencesPage 20 tDCS •  Low-level direct current •  FDA-cleared as iontophoresis devices •  Significant body of clinical literature •  Can enhance as well as degrade cognitive abilities, depending on how applied •  Strong interest from military •  Enhanced real-time cognitive abilities •  Significant variation in effect across subjects •  MOA not well-described
  • 21. Confidential Rio Grande NeurosciencesPage 21 CES •  Low-level alternating current •  FDA-cleared for treating anxiety, depression and insomnia •  Used in conjunction with counselling for treating PTSD •  US military use •  Significant body of clinical literature •  MOA not well characterized •  Where does energy go?
  • 22. Confidential Rio Grande NeurosciencesPage 22 TMS •  Direct descendent of ECT •  Designed to trigger excitable membranes •  High-power, low penetration •  FDA-cleared for treating refractory depression •  MOA not well understood •  Half-power TMS designed for home use •  FDA-cleared to treat aura-related migraine at onset •  RCT support weak •  FDA cleared on potential effectiveness and safety
  • 23. Confidential Rio Grande NeurosciencesPage 23 LLLT •  FDA-cleared for multiple non-neuroscience applications •  MOA outlined: neuroprotective and anti- inflammatory effects •  Early trial failed Phase III clinical trial in stroke •  Subset appeared to benefit •  Potential applications in cognition and neurorehabilitation
  • 24. Confidential Rio Grande NeurosciencesPage 24 Trigeminal Nerve Stimulation •  Buccal spatially separated stimulation for improved neuroplasticity •  MOA not well-characterized •  Placebo effect > 40% •  Transdermal TNS cleared by FDA for treating migraine •  CE-marked for treating epilepsy •  MOA not well characterized
  • 25. Confidential Rio Grande NeurosciencesPage 25 Emerging NIBS •  ELF-EMF •  Magnetic field effects •  Variable effects •  Dependent on signal characteristics •  Transcutaneous Vagal Nerve Stimulation •  Auricular stimulation of vagal nerve •  Treating epilepsy, depression •  Transcranial ultrasound •  Enhanced cognitive performance •  DARPA prototype
  • 26. Confidential Rio Grande NeurosciencesPage 26 •  Steven Gluckstern, EdD, MBA – Chairman & CEO -  Chairman & CEO, Ivivi Health Sciences -  Chairman, Zurich Scudder Investments -  Expertise: Leadership, Entrepreneurship, Finance, Public Company Executive Management •  Stephen Juelsgaard, JD DVM – Board member -  Former General Counsel – Genentech Inc. -  Expertise: Leadership, Public Company Executive Management, Intellectual Property Development, FDA Board of Directors
  • 27. Confidential Rio Grande NeurosciencesPage 27 •  Steven Gluckstern – Chairman & CEO •  Sean Hagberg, PhD – Chief Strategist -  Clinical Assistant Professor, Neurosurgery, UNM -  Co-founder and Chief Science Officer, Ivivi Technologies -  Expertise: Clinical Innovation and Adoption, Strategy, tPEMF Research and Development •  Blake Gurfein, PhD – Chief Science Officer -  Assistant Professor of Medicine, UCSF -  NIH–funded Principal Investigator -  Expertise: Neuroimmunology, CNS Pathology, Scientific Project Management •  David Muehsam, PhD – Senior Biophysicist -  Visual Institute of Developmental Arts & Sciences, Bologna, Italy -  Expertise: Bioelectromagnetic Therapeutics, Biophysical Transduction Mechanisms, Mathematical Modeling •  Shamini Jain, PhD – Director of Technology Discovery -  Founder and Executive Director, Consciousness and Healing Initiative -  Assistant Professor, Psychiatry & Behavioral Medicine, UCSD -  Expertise: Psychoneuroimmunology, Clinical Psychology, Program Management •  Michael Weisend – Senior Scientist -  Senior research Scientist, Wright State Research Institute -  Associate Professor of Translational Neuroscience, Mind Research Institute -  Expertise: Clinical Neurophysiology, Neurocognition, tDCS and other NIBS modalities Executive Management Team
  • 28. Confidential Rio Grande NeurosciencesPage 28 •  Mitchel Berger, MD, Medical Advisory Chair -  Neurosurgery Chair, UCSF -  Member of NFL Head, Neck, & Spine Medical Committee -  Fmr. President, American Association of Neurological Surgeons •  Adam Gazzaley, MD, PhD, -  Professor Neurology, Physiology and Psychiatry, UCSF -  Director, Neuroscience Imaging Center, UCSF -  Director, Gazzaley Lab for Cognitive Neuroscience Research, UCSF •  David Hovda, PhD -  Director, UCLA Brain Injury Research Center, Professor of Neurosurgery, Biomedical Physics, Molecular & Medical Pharmacology -  Fmr. President, National Neurotrauma Society •  Geoff Manley, MD, PhD -  Professor and Vice Chair Neurosurgery, Co-Director Brain and Spinal Injury Center, UCSF -  Chief of Neurosurgery, SF General Hospital -  Principal Investigator: Transforming Research And Clinical Knowledge in TBI (“TRACK-TBI”, multicenter $18.8 million, five year NINDS Grant) •  Pratik Mukherjee, MD, PhD -  Director, Center for Imaging of Neurological Diseases -  Professor of Radiology, Biomedical Imaging and Bioengineering, UCSF -  Principal Investigator TRACK-TBI •  Howard Yonas, MD -  Neurosurgery Chair, UNM -  Director, UNM Cerebrovascular Center -  Founder and Co-Director of the UPMC Stroke Institute Medical Advisory Board
  • 29. Confidential Rio Grande NeurosciencesPage 29 Military Medical Advisory Council •  Gale Pollock CRNA, FACHE, FAAN, Chair -  Fmr. Chief, Army Nurses Corp -  Member of NFL Head, Neck, & Spine Medical Committee -  Fmr. Acting Surgeon General, U.S. Army -  Retired Major General, U.S. Army •  James Ecklund, MD -  Chairman, Department of Neurosciences Inova Fairfax Hospital -  Fmr. Chairman, Neurosurgery Program - National Capital Consortium (includes Walter Reed Army Medical Center, National Naval Medical Center and the Uniformed Services University) -  Retired Colonel and trauma surgeon, U.S. Army •  Kenneth Farmer, MD -  Fmr. Chief, North Atlantic Regional Medical Command and Walter Reed Army Medical Center -  Fmr. Deputy Surgeon General, U.S. Army -  Fmr. Chief of Staff, U.S. Army Medical Command -  Retired Major General, U.S. Army •  John Holcomb, MD -  Director, Center for Translational Injury Research, Vice Chair and Professor Department of Surgery, University of Texas Houston -  Fmr. Director, U.S. Army Institute of Surgical Research -  Retired Colonel and trauma surgeon, U.S. Army
  • 30. Confidential Rio Grande NeurosciencesPage 30 Special Advisors Rio Grande Neurosciences •  Arthur Pilla, PhD -  Senior Scientific Advisor, Professor Emeritus Mt. Sinai Medical School, Columbia University -  Inventor of tPEMF and bone growth stimulator -  Co-founder EBI, Ivivi Technologies •  Robert Cantu, MD -  Clinical Professor of Neurosurgery, Boston University, Co-Director, Center for the Study of Traumatic Encephalopathy, BU -  Chairman, Department of Surgery, Chief Neurosurgery Service, Director, Service Sports Medicine at Emerson Hospital (MGH) •  Joseph C. Maroon, MD, FACS -  Professor and Vice Chairman, Department of Neurological Surgery and Heindl Scholar in Neuroscience, UPMC -  Team neurosurgeon, Pittsburgh Steelers (since 1981) •  Milton McColl, MD -  Former NFL Player, San Francisco 49ers -  Fmr. Venture Partner, New Leaf Ventures -  Fmr. President, Neurovascular Div., Boston Scientific •  Christopher Nowinski -  Co-Founder and Executive Director, Sports Legacy Institute (SLI) -  Co-Director, Center for the Study of Traumatic Encephalopathy; advisor, NFL Players Association, Mackey-White Traumatic Brain Injury Committee
  • 31. Confidential Rio Grande NeurosciencesPage 31 •  Accomplished and visionary management team •  Addressing vast and unprecedented unmet medical need •  Distinguished medical advisors and principal investigators •  Significant IP portfolio and ongoing IP development •  Substantial opportunity to acquire and/or license NIBS technologies •  “First-to-market” public vehicle for driving consolidation, innovation and adoption of emerging NIBS therapeutics RGN Summary
  • 32. Appendix – Supporting science slides for tPemf/Theracap Confidential Rio Grande NeurosciencesPage 32
  • 33. Confidential Rio Grande NeurosciencesPage 33 Our PEMF device •  Safe and well-tolerated in the periphery •  Provides anti-inflammatory effects •  Reduces edema and pain •  Enhances blood flow Large unmet need for TBI therapies •  Hallmarks of TBI pathology are neuroinflammation, edema, reduced blood flow, and neuronal death •  Whereas drugs may not pass the blood brain barrier, PEMF is an inductive therapy that can easily treat the CNS CNS-PEMF Rationale
  • 34. Confidential Rio Grande NeurosciencesPage 34 PEMF Effect on Post-op IL-1β •  tPEMF technology has been demonstrated in two post-surgical controlled trials to significantly reduce pain, swelling, pain medication use and key inflammatory biomarker IL-1β IL-1β levels 50-75% lower in treated patients; pain and pain medication use reduced by 50% (left: n = 24; right: n = 32) N=24 (12/12) N=32(16/16)
  • 35. Confidential Rio Grande NeurosciencesPage 35 tPEMF and Traumatic Brain Injury Rio Grande Neurosciences Rodents with concussion were treated with SHAM or tPEMF for 6 hours Neuroinflammation occurs after brain injury and higher levels of the inflammatory cytokine IL-1β are associated with worsened pathology and poor functional outcomes (i.e., greater disability) p ≤ 0.02 * Rasouli et al. 2012 tPEMF treated animals had 5-fold less IL-1β in the CSF 6 hours after concussion compared to SHAM-treated animals
  • 36. Confidential Rio Grande NeurosciencesPage 36 tPEMF and Traumatic Brain Injury Rio Grande Neurosciences Rodents with a penetrating TBI treated with SHAM or tPEMF tPEMF treated animals had 5-fold less IL-1β in the CSF 18 hours after injury compared to SHAM control animals. p ≤ 0.001 p ≤ 0.015 Rasouli et al. 2012
  • 37. Confidential Rio Grande NeurosciencesPage 37 tPEMF Reduces Numbers of Activated Microglia 0 5 0 1 0 0 1 5 0 2 0 0 2 5 0 c o n t r o l L M E P E M F L M + PE OX-42 + microglia * 0 5 0 1 0 0 1 5 0 2 0 0 2 5 0 c o n t r o l L M E P E M OX-42 + microglia Rio Grande Neurosciences Primary co-cultures of neurons and microglia stimulated with LPS (inflammatory agent) for 24h followed by 30 min of tPEMF treatment Microglia are resident immune cells in the brain and activated microglia (OX-42+) are a focal source of local inflammation p < 0.05 Quantification demonstrated that there were significantly fewer activated microglia in tPEMF treated cultures, evidence of anti-neuroinflammatory effects
  • 38. Confidential Rio Grande NeurosciencesPage 38 tPEMF Reduces Microglial Reactivity After Injury control PEMF Rio Grande Neurosciences Neuroinflammation induced in response to damage caused by a penetrating injury in rodent brain. tPEMF applied twice daily for one week. Staining for OX-42+ activated microglial PEMF treated tissue (right) exhibits visibly less microglial activation
  • 39. Confidential Rio Grande NeurosciencesPage 39 tPEMF Effects In High Intracranial Pressure (ICP) Model Increased Arteriole Diameter Increased Tissue Oxygenation Rat model of high intracranial pressure •  ICP raised to 30mmHG •  Treated with PEMF for 30 minutes •  Arteriole diameter was measured using intravital 2-photon microscopy •  Tissue oxygenation quantitated measuring NADH auto- fluorescence •  NADH is fluorescent and whereas oxidized NAD+ is not p < 0.05 p < 0.05
  • 40. Confidential Rio Grande NeurosciencesPage 40 tPEMF Effects In High Intracranial Pressure (ICP) Model Reduced Microvascular Shunting * Reduced BBB Permeability Rat model of high intracranial pressure •  Ratio of microvascular shunting to capillary flow (nutritive blood flow) was lower in PEMF treated animals •  The amount of leakage of a fluorescent agent from the CNS vasculature into the brain parenchyma was lower in PEMF treated animals •  Suggesting improved blood-brain- barrier function p < 0.05 p < 0.05
  • 41. Confidential Rio Grande NeurosciencesPage 41 tPEMF Effects in Sub-Acute Stroke Model Sub-acute stroke study demonstrated substantial effects of tPEMF on gene expression in animals in later stage stroke recovery (7 days) •  Increased anti-inflammatory gene expression •  Decreased inflammatory & apoptotic gene expressions PEMF BID for 15 minutes Starting 3 days post-stroke for 7 days
  • 42. Confidential Rio Grande NeurosciencesPage 42 Neuroprotective Effects of tPEMF Neuronal Insult Model •  Primary cortical neurons exposed to oxygen and glucose deprivation (OGD) for 1, 2, or 3 hours •  PEMF treatment for 30 minutes at the onset of OGD •  Cells stained for TUNEL, a marker of DNA fragmentation and apoptosis •  50% fewer apoptotic cells found in PEMF-treated compared with untreated cultures
  • 43. Confidential Rio Grande NeurosciencesPage 43 PEMF effects on Long-Term Potentiation PEMF treatment in a hippocampal slice model significantly increased synaptic transmission, which is associated with long-term potentiation (LTP), a process required for learning and memory.
  • 44. Confidential Rio Grande NeurosciencesPage 44 Effects of tPEMF on EAE 0 1 2 D0 D1 D2 D3 D4 D5 D6 D7 D8 D9 D10 D11 D12 D13 D14 D15 D16 D17 D18 D19 D20 D21 D22 D23 D24 D25 D26 D27 D28 D29 Day MeanEAEscore Control PEMF Sham PI: Sergio Baranzini (UCSF) EAE: Inflammatory autoimmune model of multiple sclerosis Scoring: 0 (healthy) – 5 (moribund) PEMF or Sham treatment of mice with EAE (n = 10 per group) Treated 15 minutes twice per day Repeated Measures ANOVA, p = 0.077 Treatment * Time
  • 45. Confidential Rio Grande NeurosciencesPage 45 Ongoing Research Collaborations Basic Science Studies Michael Whalen, M.D. Ph.D. – Harvard University •  Effects of PEMF on rodent concussion and learning. Sergio Baranzini, Ph.D. – University of California San Francisco •  Effects of PEMF on EAE, an animal model of multiple sclerosis. Lee Goldstein M.D. Ph.D. – Boston University •  Use of PEMF to prevent CTE pathology and tau deposition. Pejmun Haghighi, Ph.D. – Buck Institute for Research on Aging •  Effects of PEMF on synaptic function Kiran Bhaskar Ph.D. – University of New Mexico •  Anti-neuroinflammatory effects on microglia and astrocytes •  Genomics interrogation of PEMF effects on inflammation
  • 46. Confidential Rio Grande NeurosciencesPage 46 Ongoing Research Collaborations Clinical Studies Hunt Batjer, M.D. – UT Southwestern (December 2014) •  Randomized Controlled Trial – PEMF treatment of sports concussion •  High school and college football players •  Focus: latency of symptom resolution and return to play Adam Gazzaley, M.D. Ph.D. – UCSF (Ongoing) •  Effects of PEMF on cognitive function and multitasking performance Leon Morales-Quezada, M.D. – Harvard University •  Effects of PEMF on EEG activity Howard Yonas, M.D. – University of New Mexico •  PEMF treatment of severe traumatic brain injury
  • 47. Confidential Rio Grande NeurosciencesPage 47 Pending Grant Support National Institutes of Health National Institute of Neurological Disorders and Stroke •  STTR Fast Track Phase I/II •  Effects of PEMF as a treatment for post-concussion syndrome. •  Co-PI – Ross Zafonte PhD (Harvard Medical School) •  Submission: December 5th, 2014