Monarch™ eTNS™ System Talking to Your Doctor by NeuroSigma Itis unusual for patients to suggest a treatment option that's unfamiliar to their physician. But it is possible you will be in that position. The concept of nerve stimulation - specifically, vagus nerve stimulation (VNS) ~ to treat epilepsy and depression is wellknown. Your physician, however, might not know about the Monarch™ eTNS™ system as a treatment option. Since you will need a doctor's prescription to obtain the Monarch System, NeuroSigma has developed an information page designed to help you start a conversation with your physician about the therapy. If you want to find out more about the Monarch System, or if your doctor has additional questions, contact us and a NeuroSigma representative will respond, What does eTNS mean? It's an abbreviation for extemal Trigeminal Nerve Stimulation. What is the Monarch eTNS System? The Monarch system is a non-invasive therapy approved in the European Union and Canada for the adjunctive treatment of epilepsy and depression in patients ages 9 and older. How does it work? ‘small electric patch is applied to the forehead just above the eyebrows, Lead wires connect the patches to a hand-held device thal can be fastened to a belt, carried in 2 pocket, or placed beside your bed. Mild electrical currents then stimulate the trigeminal nerve. Patients typically report a tingling sensation that does not interfere with daily activities or sleep, When does the treatment occur? Patients use eTNS at their convenience. Most choose to have the stimulation therapy occur while they sleep. Who are good candidates? Patients may try the Monarch if they have been diagnosed with epilepsy or depression and the symptoms are not successfully managed with medication. Typically, patients have tried at least two drug therapies. before considering TNS. Where was the treatment developed? eTNS was invented by a team of doctors and researchers at the University of California, Los Angeles (UCLA). UCLA physicians were involved in some of the original studies of vagus nerve stimulation (VNS) for the treatment of epilepsy, and began to develop eTNS as a non-invasive alternative to \VNS. eTNS has now been used for a decade in clinical studies at UCLA. NeuroSigma is making this treatment available to patients throughout the European Union and Canada. Where can | read peer-reviewed papers that have been published in scientific journals? Please visit NeuroSigme's publications page: http://www. monarch-eTNS. com/physicians/publications. How do you obtain it? A patient must have a physician's prescription to acquire the Monarch eTNS system, Is the Monarch eTNS System covered by insurance? No, at this time the Monarch is not covered by insurance, please check back regularly for updates on reimbursement. How much does the Monarch eTNS System cost? ‘The Monarch eTNS System can be purchased directly from NeuroSigma. The starter kit is €800 and includes everything a patient needs to begin therapy and a 4-week supply of electric patches. Additional patches can be purchased from NeuroSigma for €10 each NeuroSigma, Inc. 410960 Wilshve Boulevard Sute 1230 Los Angeles, CA 99024 Phone: (310} 473-3100,