Slide 1: Accessing the Power of the Vagus Nerve Stimulation with electroCore
b4 SOx electroCore” Accessing the Power of the Vagus Nerve Stimulation with electroCore™ Dr. Peter Staats, MD, MBA, Founder and Chief Medical Officer Dan Goldberger; CEO electroCore, Inc. November 21, 2023 NASDAQ: ECOR
Slide 2: Forward Looking Statement
Forward Looking Statement In addition to historical information, this presentation may contain forward-looking statements with respect to our business, capital resources, strategy and growth reflecting the current beliefs and expectations of management made pursuant to the safe harbor provisions of
Slide 3: Table of Contents
Table of Contents 1. The Vagus Nerve 2. History and Science of Vagus Nerve Stimulation & and Mechanism of Action (MOA) 3. Clinical Progress 2) gammacCore 4. Product Pipeline Sapp bare ~_.# b4 SOx electroCore” NASDAQ: ECOR
Slide 4: The Vagus Nerve
The Vagus Nerve ys : Sex electroCore
Slide 5: The Vagus Nerve
The Vagus Nerve + The tenth cranial nerve, or cranial nerve X - It is the longest and most widely distributed cranial nerve in the body - Affects various organ systems in the body-predominantly the head, thoracic and abdominal organs + Contains both sensory and motor functions b4 5 SOx electroCore N
Slide 6: Vagus Nerve Functions
Vagus Nerve Functions * CNS: Reduces nociception, reduces cortical spreading Liver depression, and other brain modulation effects; Kidney increases glymphatic flow, regulation of Small intestine neurotransmission for “fight or flight,” cognition * Cardiac: Reduces heart rate and blood pressure « Pul
Slide 7: History of Vagus Nerve Stimulation
History of Vagus Nerve Stimulation FDA clears implanted Suppression of seizures VNS (iVNS) for nVNS investigational by manual neck carotid refractory epilepsy iVNS cleared for chronic nVNS cleared for for a broad range of artery massage (crude Cyberonics now treatment-resistant acute treatment of di
Slide 8: nVNS Mechanisms of Action (MOA)
nVNS Mechanisms of Action (MOA) y) : Sex electroCore
Slide 9: nVNS: An Integrative Mechanism of Action
nVNS: An Integrative Mechanism of Action There are multiple known mechanism of vagus nerve stimulation: b4 SOx electroCore’ NEUROPROTECTION Decrease inflammation and protect brain integrity PAIN MITIGATION Decrease pain signaling and recognition CORTICAL SPREADING DEPRESSION Decreases hyperactive el
Slide 10: Polyvagal Theory
Polyvagal Theory « Polyvagal theory states that when a person feels safe, their body is able to engage in homeostatic “rest and digest” behaviors. + When the body is locked in a sympathetic state (attack/defense mode), the ability to heal, digest, learn, etc., is inhibited. * The vagus nerve is the
Slide 11: Mechanism of Action: Autonomic Nervous System
Mechanism of Action: Autonomic Nervous System « nVNS decreases sympathetic tone? + Promotes a healthy stress response ¢ Preliminary studies in patients with Posttraumatic stress disorder (PTSD) suggests nVNS can improve PTSD symptomatology’ + Patients reported a decrease in PTSD symptoms (PCL, HAM-A
Slide 12: Mechanism of Action: Pain Management
Mechanism of Action: Pain Management « nVNS suppresses the activation of trigeminal neurons! * Trigeminal allodynia, a key feature of migraine and other Trigeminal Autonomic Cephalalgia (TACs), responds to VNS + Inhibitory effects can last up to 3 hours after stimulation ¢ Unilateral nVNS treatment
Slide 13: Mechanism of Action: Cortical Spreading Depression (CSD)
Mechanism of Action: Cortical Spreading Depression (CSD) « nVNS suppresses CSD susceptibility ¢ Efficacy is comparable to that of migraine preventive drugs « Mechanistic effect takes ~30 minutes to emerge and extends to 2180 minutes (vs. 4+ weeks for preventive pharmacologic effects to emerge) ¢ Eff
Slide 14: Mechanism of Action: Neuroprotection
Mechanism of Action: Neuroprotection « nVNS has an inhibitory effect on pro-inflammatory cytokine activity * Cholinergic Anti-Inflammatory Pathway (CAP) + Reduction in cytokine storm, mast cell activity + TNF-alpha, IL-6, IL-1, HMGB-1 ¢ Upregulation of NE, ACh, and 5-HT « nVNS is currently being stu
Slide 15: Mechanism of Action: Summary
Mechanism of Action: Summary Autonomic Nervous System functionality: regulation of autonomic nervous system + Reduces sympathetic tone, leading to anxiety and stress reduction Cortical Spreading Depression (CSD): nVNS reduces CSD, a neuronal activity that precedes migraine aura + nVNS suppresses CSD
Slide 16: Clinical Progress
Clinical Progress ys : Sex electroCore
Slide 17: nVNS Research - Neuropsych (PTSD/OUD)
nVNS Research - Neuropsych (PTSD/OUD) Indication No. of Patients Status Key Endpoints institution(s) PTSD (Veterans) 88 Enrolling SETTELER, een Sargiem San Diego VA, UCSD mTBI with PTSD (Veterans) 400 Enrolling Imaging, Memory, Stress ALR ais PTSD -—non-TBI (Veterans) 80 Pending Clinical and Physiol
Slide 18: Thesis Behind nVNS in Posttraumatic Stress Disorder (PTSD)
Thesis Behind nVNS in Posttraumatic Stress Disorder (PTSD) nVNS can influence the autonomic, neuroendocrine, and neuroimmunology systems ° he neurobiology of PTSD includes: Alterations in brain structure and function o Imbalances in neurotransmitters o PTSD symptomsare associated with hypothalamic—p
Slide 19: Posttraumatic Stress Disorder (PTSD) — Breakthrough Designation
Posttraumatic Stress Disorder (PTSD) — Breakthrough Designation gammaCore™ Non-Invasive Vagus Nerve Stimulation(nVNS) Receives Breakthrough Device Designation for Treatment of Posttraumatic Stress Disorder (PTSD) AVNS reduces symptoms of PTSD by 31% in sham-controlled study ROCKAWAY, N.J., Jan. 12,
Slide 20: Substance Abuse Disorder and Opioid Use Disorder (OUD)
Substance Abuse Disorder and Opioid Use Disorder (OUD) Pain is an important component of opioid withdrawal; detoxification period can involve intense pain both can complicate recovery from OUD Pain conditions are often a precursor to the development of OUD nVNS may reduce behavioral and physiologica
Slide 21: National Institute on Drug Abuse (NIDA) Grant
National Institute on Drug Abuse (NIDA) Grant National Institutes of Health Awards Grant for Pivotal Clinical Trial of gammaCore™ (nVNS) in Patients with Opioid Use Disorders ROCKAWAY, N.J., April 26, 2023 (GLOBE NEWSWIRE) ~ electroCore. Inc. (Nasdaq: ECOR), a commercial-stage bioelectronic medicine
Slide 22: Parkinson's Disease (PD)
Parkinson’s Disease (PD) POF | pans none * Parkinson's Disease as a complex multisystem disorder in which core impairments are underpinned by deficits in multiple neurotransmitter systems as well as age-related neurodegeneration * Recent research has shown that there is a loss of acetylcholine in th
Slide 23: Parkinson's Disease
Parkinson’s Disease * Emerging Evidence’ TNF-a vs Glutathione i Asso Bx» 100 2 a Pir a. : Lf ida? a8 Ugo: Sad -20 oes “See © 20 om com 4 on ~ F 2 50. 5 r @ o & a i i : 5 BDNF a ‘Stige woloety| vanabalty 1. Mondal et.al. Na y SOx electroCore’ Steptime Stepength asymmetry asymmoty ‘Step width NASDAQ:
Slide 24: NFLPA Grant
NFLPA Grant b4 SOx electroCore’ gammaCore™ Non-Invasive Vagal Nerve Stimulation Selected for Study Funded by the National Football League (NFL) and National Football League Players Association (NFLPA) on Alleviating Concussion Symptoms ROCKAWAY, NJ, July 06, 2023 (GLOBE NEWSWIRE) -- electroCore, Inc
Slide 25: Stroke Data Presented at World Stroke Conference
Stroke Data Presented at World Stroke Conference b4 SOx electroCore’ Data Highlighting Non-invasive Vagus Nerve Stimulation (nVNS) for Treatment of Acute Neurological Injury Presented at 2023 World Stroke Congress “VANQUISH” Clinical Trial (n=40) suggests safety and efficacy of nVNS for the Treatmen
Slide 26: General Wellness User Study
General Wellness User Study’ When coming into this study, what were Ona scale from 1 to 10, how effective was you hoping to improve? the product at improving the following? 8 100% 6 75% 50% 25% G % 0 J Re oa é Re @ e cs) R é wos s eo S ax s§ s Nev” o Bes clecttoCore NASDAQ: ECOR iene aay
Slide 27: TAC-STIM Force and Mission
TAC-STIM FORCE AND MISSION TRAINING RELEVANT RESULTS‘ + Foreign Language Initial Acquisition Program + School Houses + Special Ops training + Other specific training environments TAC-STIM Enhances ISR Synthetic Aperture Radar Training MISSION SUPPORT + Preparation TAC-STIM Improves Cognitive Skill +
Slide 28: Product Pipeline
Product Pipeline ys : Sex electroCore
Slide 29: FDA Cleared Indications to Treat Medical Conditions
6 FDA Cleared Indications to Treat Medical Conditions gammaCore™ (non-invasive vagus nerve stimulator) is intended to provide non-invasive vagus nerve stimulation (nNVNS) on the side of the neck. gammaCore is indicated for: The acute treatment of pain associated with episodic cluster headache. The a
Slide 30: Clinical Data & Regulatory Timeline
Clinical Data & Regulatory Timeline + Pivotal Data complete to support a 510(k) De Novo submission to treat the Symptoms of PTSD with nVNS + Working with the FDA now, timing uncertain + $6.5M grant from NIH and NIDA to support a Pivotal trial on the use of nVNS to treat the Symptoms of withdrawal fr
Slide 31: Adding Products to the nVNS Portfolio for Greater Market Access and Adoption
Adding Products to the nVNS Portfolio for Greater Market Access and Adoption — Rx Products Wellness Products a= 899) ' i 1 1 @ ' wh ' KK cei 5 e Existing Product aA H oe \ e | ! 1 i ' Offerings r 1 1 ! ' ! i" Liaw NX ! = 1 i ! truvaga ool ! ' 1 i ' O} : = | Future Product Offerings Se ee A, aos elec
Slide 32: Headache Market
Headache Market - Tens of millions of migraine sufferers worldwide + Therapies include lifestyle, diet, exercise, nutraceuticals, OTC medications * Roughly 8M Americans are seeing a professional about headache’ and about approximately 2.5M Americans have a prescription therapy2 + Triptans are first
Slide 33: Increasing the Size of the Rx nVNS Total Addressable Market
NASDAQ: ECOR Increasing the Size of the Rx nVNS Total Addressable Market Posttraumatic Stress Disorder (PTSD) 46,700,000" Americans will develop PTSD 8,000,0002 American adults suffer from PTSD 1. tosh nareteseareh future com/teportslgostraumstic stress disorder market $378 2p A Milieu con er eta di
Slide 34: Leveraging nVNS in the $5 trillion Digital Health and Wellness Market
Leveraging nVNS in the $5 trillion Digital Health and Wellness Market “After Using Truvaga I Feel..." 100% 15% $20.6 billion global om stress market? 25% 5.3% US Stress Market 0% CAGR(‘)? LessAnsious LessStressed Calmer More Energy improvedSleep Happier @® 7 days @® 20 Days Digital Heath & Wels Mark
Slide 35: Commercial Strategy
Commercial Strategy Grow prescription nVNS business Our VA Hospital channel is accelerating and can be scaled * Replicate the VA model with Joerns healthcare in a managed care system * Grow our cash pay clinician dispense channel while we work towards broader reimbursement ¢ Add product to our presc