tVNS Health Gmbh is a medical technology sales company based in Grünwald, Germany, that has been responsible for the global distribution, services, and operations management of tVNS devices. About Us tVNS Health Gmbh is a medical technology sales company based in Germany, responsible for the global distribution, services, and sales of tVNS® non-invasive auricular vagus nerve stimulation devices in Eastern Europe, Scandinavia, Asia, Africa, South America and Italy. The developer and manufacturer of tVNS® devices is tVNS Technologies GmbH based in Erlangen, Germany. Since the medical approval of the Cerbomed Nemos® device as a first non-invasive auricular vagus nerve stimulation medical device in 2010, Cerbomed Nemos® and the new tVNS® have been used in thousands of treatments globally and significantly improved patients' quality of life. Meet the Founders Berkay Gezen is an enthusiastic professional with 28+ global business development and medical brand management. He has served as the global commercial director of CardiAid, brand for 11 years, from the design of the brand to its expansion in over 65 countries of the world. Following his creative vision of AED and his experience in global development, he became the founder of tVNS Health to focus on neuromodulation and vagus nerve stimulation technologies, sales, services and distribution for tVNS. With his expertise in market building, he become the implementer of projects that make a difference in more than 80 countries of the world. He has dedicated his professional life to increasing the awareness of public access defibrillators and neuromodulation. With his motivation, he inspires the medical community and continues to manage medical channel in more than 50 countries worldwide. Selin Erdogan Gezen Selin Erdogan Gezen She is a visionary leader in the field of neuromodulation technologies and global business development. After pivotal roles in renowned companies like Vodafone, Garanti BBVA Bank, and Hewlett Packard, as program management in innovative technology projects, Selin embarked on a new chapter as a founding partner of Nervovita Medical Technologies and tVNS Health, focusing on neuromodulation therapies. Her dedication led to the accessibility of transcutaneous vagal nerve stimulation, revolutionizing treatment options around the globe. She collaborates with leading universities and institutes in over 40 countries, driving clinical studies across various diseases. She is designing the human-machine interaction for better usability of wearable medical devices. "Our mission is to empower individuals worldwide with innovative neuromodulation and bio-electronic solutions that enhance well-being and improve lives. Committed to advancing healthcare through cutting-edge technology, we strive to be the global leader in distributing the transcutaneous vagus nerve stimulation devices. Guided by a dedication to excellence, integrity, and social responsibility, our company aims to establish a pervasive presence in the global market, ensuring accessibility to the transformative benefits of the tVNS devices. We are driven by a passion for improving mental and physical health, fostering a world where individuals can achieve their full potential and lead fulfilling lives. Our commitment extends beyond the distribution; we aim to build enduring partnerships with healthcare professionals, research institutions, and distributors to foster a collaborative ecosystem. By prioritizing customer satisfaction, continuous innovation, and ethical business practices, we aim to create a positive impact on the well-being of communities around the globe." Our Mission Our Vision "We envision a future where transformative neuromodulation technology becomes an integral part of global healthcare, revolutionizing the way individuals manage and enhance their well-being. Guided by innovation, compassion, and a commitment to excellence, we aspire to establish ourselves as the foremost global influence, ensuring universal access, recognition, and trust in the widespread expansion of transcutaneous vagus nerve stimulation technologies (taVNS). We aspire to lead the charge in advancing the field of neuromodulation, continuously pushing the boundaries of what is possible to unlock the full potential of the human body's innate healing mechanisms. By fostering a culture of curiosity, collaboration, and inclusivity, we aim to inspire a global movement toward proactive and personalized healthcare solutions. Through strategic partnerships, ongoing research, and a commitment to ethical business practices, we seek to shape a healthcare landscape where preventative and holistic approaches are celebrated. As we strive for excellence, our vision extends beyond business success to contributing significantly to the betterment of society. We see a world where the neuromodulation becomes a beacon of hope, fostering resilience, and promoting a culture of well-being that transcends borders. We are dedicated to pioneering a future where the power of neuromodulation transforms lives, creating a healthier, happier, and more connected global community." tVNS Health GmbH Headquarter Südliche Münchner Str. 62, 82031 Grünwald, Germany info@tvns.health www.tvns.health Contact tVNS Health info@tvns.health Contact Form

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tVNS is a medical treatment that involves delivering electrical impulses to the vagus nerve with the aid of a electrode. It is used in the treatment of indications such as Epilepsy, Coma, Migraine, Depression, Cognitive Disorder, Crohn's Disease, Insomnia, Autism, Tinnitus, Stroke. What is Vagus Nerve? The vagus nerve is the longest cranial nerve in the body. It comes from the Latin word, vagus, for “wandering.” That’s because it wanders throughout your body, with wide distribution connecting the brainstem to the body. Only mammals have this nerve. The vagus nerve serves as the body's superhighway, carrying information between the brain and the internal organs and controlling the body's response in times of rest and relaxation. It helps the immune system and inflammation response to disease. It has four main functions: sensory, special sensory, motor and parasympathetic. The vagus nerve also manages fears and sends information from the gut to the brain, which is linked to dealing with stress, anxiety, and fear–hence the saying, ‘gut feeling'. Historical Development of Vagus Nerve Stimulation Epilepsy has existed in human history with the first record found in a Babylonian text written 4000 years ago, and humanity has sought a cure for this disease for centuries. With the emergence of neurology in the 19th century, the mechanism between the nervous system and epilepsy was tried to be solved and the first vagus nerve stimulation was tried by a New York neurologist in the early 1880s. Over the next 100 years, the effects of vagus nerve stimulation were first investigated in animal experiments, then in humans, and in 1988, an invasive vagus nerve stimulator was surgically implanted into the cervical branch. At the beginning of the 2000s, scientists started working on alternative ways to stimulate the vagus nerve non-invasively, to eliminate the need for surgery and minimize the side effects. First generation transcutaneous vagus nerve stimulation device, Nemos, was approved in 2010 for the treatment of epilepsy and depression, and Vitos in 2012 for the treatment of pain and migraine, as the first medically approved non-invasive vagus nerve stimulation treatment in the world. Our 2nd generation device tVNS has been launched in 2021, and tVNS patient devices have become the first MDR CE-certified transcutaneous vagus nerve stimulation devices in the world, in 2023. Vagus Nerve Stimulation Effect Overview Regulation of neurotransmitter release Increase in parasympathetic activity Increase in brain neuroplasticity Reducing inflammation Increasing the secretion of serotonin and increasing the mood What Are the Effects of Vagus Nerve Stimulation? Stimulation of the vagus triggers regulatory mechanisms in the nervous, immune, autonomic, endocrine, cardiorespiratory, and gastrointestinal systems. Clinical studies on the vagus nerve have shown that the activity in this nerve is closely related to epilepsy, depression, migraine, headache, inflammatory bowel disease, Alzheimer's, arthritis and many other common disorders by activating the parasympathetic nervous system in the brain and increasing the secretion of neurotransmitters in special regions of the brain. Vagus nerve stimulation therapies are approved by FDA in the USA and CE in Europe for use in treatments such as epilepsy, mood improvement, pain relief, sleep improvement, memory enhancement and anxiety reduction. Research continues on the effects of neuroplasticity as well as its cardiac and inflammatory properties.

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During the last 20 years, basic and clinical research has unraveled many of these questions and augmented our understanding of tVNS pathways and physiologic effects. The number of publications increased exponentially within the last three years and continues to grow rapidly. Many questions have been addressed and therapeutic indications beyond the treatment of drug-resistant epilepsy and depression are steadily expanding and continue to be explored. Clinical Studies Vagus nerve stimulation (VNS) has become a therapeutic option for patients with resistant epilepsy and depression. The field of tVNS is quickly progressing due to its non-invasive nature, presenting a promising alternative to the side effects associated with invasive VNS. Notably, tVNS stands out for its accessibility, affordability, and easiness of application compared to traditional VNS methods. However, the non-invasive stimulation of the outer ear brings forth new queries regarding optimal stimulation sites, stimulus parameters, and the physiological pathways of transcutaneous auricular VNS. Over the past two decades, both basic and clinical research have made significant strides, unraveling these complexities, enhancing our comprehension of tVNS pathways and physiological effects. The exponential growth in publications over the last years underscores the expanding knowledge base. As we delve deeper, therapeutic applications and achievable objectives of tVNS beyond epilepsy and depression treatment are continually broadening, promising new horizons in the field. Redgrave 2018: Safety and Tolerability of tVNS Wrede Case Study 2019 : Sustained seizure freedom with transcutaneous vagal nerve stimulation in drug-resistant epilepsy caused by subcortical band heterotopias Yakunina 2016: Optimization of Transcutaneous Vagus Nerve Stimulation Using Functional MRI Ellrich 2019: Transcutaneous Auricular Vagus Nerve Stimulation Study Bauer 2015: Transcutaneous Vagus Nerve Stimulation (tVNS) for Treatment of Drug-Resistant Epilepsy: A Randomized, Double-Blind Clinical Trial Straube 2015: Treatment of chronic migraine with Transcutaneous stimulation of the auricular branch of the vagal nerve (auricular t-VNS): a randomized, monocentric clinical trial tVNS JOURNAL The "tVNS Special Issue", which includes 17 studies on our tVNS devices, has been published in the "Journal Autonomic Neuroscience" by Elsevier, the official journal of the International Society for Autonomic Neuroscience. Journal For more please contact us info@tvns.health

TVNS treatment in Crohn's disease. The most up-to-date health information on crohn's disease causes, symptoms, treatment options Crohn's Disease Groundbreaking Technologies for Life What is Crohn's Disease ? Crohn's disease is a type of inflammatory bowel disease that causes inflammation of the gastrointestinal tract from the mouth to the anus. This inflammation can be attached to one or more parts of the digestive system, but it is usually seen in the ileum, which is the last part of the small intestine, and in the beginning of the large intestine. Crohn's disease can cause inflammation in your digestive tract, leading to abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. Growth-development retardation in children may be signs of Crohn's disease. Extra-intestinal diseases are also observed in a quarter of Crohn's patients. These mostly occur in the skin, joints, eyes, liver and biliary tract, kidney and urinary tract, vascular heart and lungs. Crohn's Disease Symptoms Diarrhea Abdominal pains Intestinal blockages Fever Fatigue Loss of appetite and weight loss Still feeling full after using the toilet Frequent toileting is one of the early symptoms of Crohn's disease. Insomnia Tanı Yöntemleri Crohn's Disease Causes Immune system: It is possible for a virus or bacteria to trigger Crohn's disease; however, scientists have yet to identify such a trigger. When your immune system tries to fight off the invading microorganism, an abnormal immune response can cause the immune system to attack cells in the digestive tract as well. Heredity: Crohn's disease is more common in people with a family history of the same disease, so genes may play a role in the occurrence of the disease. Crohn's Disease Diagnostic Methods Blood analysis Stool analysis Stomach, small and large intestine films Colonoscopy and endoscopy CT and MRI images Crohn's disease can occur at any age, but it usually occurs when the disease is young. Most people who develop Crohn's disease are diagnosed before they reach the age of about 30. You are at higher risk for the disease if you have a first-degree relative with the disease, such as a parent, sibling, or child. About 1 in 5 people with Crohn's disease have a family member with the disease. Facts About Crohn's Disease Treatment Options for Crohn's Disease Medication Steroid drugs: These are drugs to reduce inflammation in the digestive system. Drugs for the immune system: These are drugs used to control the immune system. More information Surgical treatment Most Crohn's Disease patients may need surgical treatment. Removing the problematic parts of the digestive system and reconnecting them to healthy parts is the aim of surgical treatment. More information Crohn's Disease Diet In general, the patient is given a high-energy, abundant protein, low-fiber, low-fat diet rich in vitamins and minerals. For some patients, consumption of milk and dairy products is prohibited. More information Transcutaneous Vagus Nerve Stimulation (tVNS) tVNS ® reduces inflammation in the intestine, allowing the intestine to do its job more healthily. More information Contact us

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tVNS, non-surgical treatment option for epilepsy. The most up-to-date health information about epilepsy causes, symptoms, treatment options Less seizures - more from life. Treat drug-resistant epilepsy wit h tVNS® Epilepsy An epileptic seizure is a clinical condition that occurs when the normal activity of the brain is disrupted by the temporary abnormal electrical acti vity in the nerve cells. Epilepsy is the recurrence of epileptic seizures and is considered a chronic disease. While anticonvulsants are commonly prescribed, many epileptic patients are resist ant to drug therapy. Treatment Options for Drug Resistant Epilepsy Epilepsy Surgery There are two methods of neurosurgery: removal of the brain region that causes seizures and surgical cutting of the neural pathways that cause seizures to spread. However, since these methods are only suitable for focal epilepsies, only a small proportion of epilepsy patients are suitable for this invasive procedure. In deep brain stimulation, electrodes are implanted in the brain. These electrodes are attached to a battery operated stimulator that is usually placed under the patient’s collarbone. Epileptic activity can be specifically affected at the baseline through current stimuli. Deep Brain Stimulation Invasive Vagus Nerve Stimulation In some patients, a treatment called “vagus nerve stimulation”, also known as brain pacemaker surgery, can be applied. With a surgical intervention, a battery is placed under the chest and an electrode wire is placed in the vagus nerve in the neck. With the help of the electrode, the vagus nerve is stimulated at regular intervals, which may reduce seizures. Transcutaneous Vagus Nerve Stimulation The tVNS® auricular vagus nerve stimulation device is a treatment option that provides vagus nerve stimulation through the ear with a smartphone-sized device and a special headset without any surgical intervention. From there, as with invasive vagus nerve stimulation, higher centers of the brain are activated, triggering an anticonvulsant effect. How does tVNS® treat epilepsy? In transcutaneous vagus nerve stimulation, mild electrical impulses are given to the cymba concha region in the outer auricle through a special ear electrode. These stimuli activate the vagus nerve, which passes directly under the skin in this region (auricular branch of the vagus nerve). The nerve first transmits these impuleses to the Nucleus Tractus Solitarius in the brain stem and are transmitted to many different regions of the diencephalon (midbrain) and cerebrum. These stimuli are also transmitted to the Norepinephrine (Noradrenaline) center, the Locus Coeruleus, and Serotonin center, the Dorsal Raphe nucleus. These transmitters affect one’s clarity, energy, and confidence. These 2 centers send these neurotransmitters to the entire brain, specifically to the parts that control thinking and feeling. more serotonin and norepinephrine are then sent to the Prefrontal Cortex and are inhibited in the Hippocampus and Anterior Thalamus regions, which reduces anxiety and panic. This mechanism causes the frequency or severity of seizures to be reduced or stopped entirely. tVNS has helped hundreds of patients suffering from epilepsy to reduce or completely eliminate their seizures and lead a more self-determined life, without the need for surgery. “It’s wonderful that with tVNS® I have found a therapy option that makes me feel better without needing surgery.” Katja S. from Munich

tVNS non-surgical, drug-free treatment with low side effects. The most up-to-date health information on the causes, symptoms, and treatment options of depression. Gain more freedom and self-determination. Treat depression with tVNS®. Depression Depression is a mood disorder that negatively affects the way one thinks and feels, interfering with one’s daily activities. It is characterized by a p ersistent feeling of sadness and hopelessness along with a loss of interest in activities that were once enjoyed. Treatment Options for Depression Medication There are different types of medications that can be used to treat depression including serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), Monoamine Oxidase Inhibitors (MAOIs), tricyclic and tetracyclic antidepressants, and many others. The doctor or pharmacist will inform patients about the possible mild or severe side effects of these drugs upon prescription, which will be followed by close monitoring for the first few weeks after starting the medication. Psychotherapy Psychotherapy is a general term for continuing treatment of depression which entails talking to a mental health professional about one’s condition and related issues. Psychotherapy is also known as talk therapy or psychological therapy. Different types of psychotherapy, such as cognitive behavioral therapy or trauma therapy, can be effective for depression depending on the patient. Hospital Treatment Some cases of severe depression requir e in-patient hospital stays. This may be necessary when the individual is unable to properly care for themselves and is in danger of harming themselves or others. Psychiatric treatment in a hospital can help an individual stay calm and safe until their mood improves. Partial hospital or day treatment programs may also help some individuals. Electroconvulsive therapy (ECT) In EC T, electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression. ECT is usually used for people who don’t get better with medications, can’t take antidepressants for health reasons, or are at high risk of suicide. Transcranial magnetic stimulation (TMS) TMS may be an option for those who haven’t responded to antidepressants. During TMS, a treatment coil, placed against your scalp, sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression. Transcutaneous Vagus Nerve Stimulation (tVNS) The tVNS® auricular vagus stimulation device is a treatment option that provides vagus nerve stimulation through the ear. The increase in parasympathetic activity from the stimulation provides relaxation and a calming effect. The increased release of serotonin provides a positive change in mood and the increased sleep quality leads to an improvement in the overall quality of life. Significant decreases in Hamilton Rating Scale for Depression, increase in Resting State Functional Connectivity and decrease in Beck Depression Inventory can be observed. tVNS® has very low side effects compared to drug options. tVNS® has helped many patients suffering from depression to reduce or completely eliminate their symptoms and lead a more self-determined and free life. Contact Us

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tVNS treatment in sleep disorders. The most up-to-date health information on sleep disorders causes, symptoms, treatment options INSOMNIA (SLEEP DISORDER) What is Insomnia? Insomnia is a common sleep disorder that makes it difficult to fall asleep and stay asleep, or to wake up too early and not be able to go back to sleep. People with insomnia feel tired when they wake up. Insomnia can reduce not only energy level and mood, but also health, work performance and quality of life. It is the disease of not being able to sleep in sufficient time and restful sleep. During the existence of the disease, symptoms such as irregularity in sleeping hours, sudden night awakenings, difficulty falling asleep after waking up, and waking up very early in the morning are observed. The existence of a regular sleep time and long naps does not mean that we will wake up the next day rested and ready to work. In studies on sleep and sleeping problems, it is said that an adult individual should sleep 7-8 hours every night. However, the resting process, which differs from person to person, can change the person's sleep duration. Types of Insomnia Acute insomnia: It refers to the short-term appearance of insomnia. Acute insomnia usually occurs after a stressful day or on days when mental tension is high. Our body clock has a hard time showing when it's time to rest on such difficult days. This irregularity, which usually lasts for 1 to 2 days, continues unti l we feel better. There are signs of acute insomnia that can last up to 4 weeks. Chronic Insomnia: A sleep disorder that lasts for 1 month or more is called chronic insomnia. A large proportion of 10-15% of adults suffer from chronic insomnia. Compared to acute insomnia, chronic insomnia requires medical attention. The main cause of this type of disorder is usually the presence of major depression. Hypersomnia: characterized by excessive sleepiness and excessive daytime sleep requirements. It is less common than insomnia. Narcolepsy : Includes excessive daytime sleepiness and abnormal findings in daily REM sleep for at least 3 months. Narcolepsy is an abnormality in the sleep mechanism, especially in the REM mechanism. Treatment Options for Insomnia Sleep Techniques Airflow in and out of the lungs during breathing Blood oxygen levels. Body position. Brain waves (EEG) More information CPAP Titration (Mask Therapy) Some cases of severe depression require a hospital stay. This may be necessary in situations where the individual is unable to take care of themselves properly and is in danger of harming themselves or someone else. More information Polysomnography Sleep test. It is a process that is done by recording with the help of devices all night long to determine the quality of sleep and to find the cause of the sleep disorder. More information Transcutaneous Vagus Nerve Stimulation (tVNS) Communication between the gut and the brain is provided by the vagus nerve. More information WE DESIGN THE MEDICAL TECHNOLOGIES OF THE FUTURE Contact us