Expo Day: MindMaze, SharpBrains, Watson Centre for Brain Health

2. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Sponsors Expo Day! 8.15am. Charlie Hartwell at The Bridge Builders Collaborative 9am. Dr. Bob Bilder at UCLA 9.30am. Ron Riesenbach at the Canadian Centre for Aging and Brain Health Innovation (CC-ABHI) --10am. Break-- 10.30am. Dr. Daniel Perez-Marcos at MindMaze 11am. Alvaro Fernandez at SharpBrains 11.30am. Mark Watson at the Watson Centre for Brain Health --Noon. Lunch break-- 1pm. Franck Tarpin-Bernard at Scientific Brain Training (SBT) 1.30pm. Jessica Poulin at the Arrowsmith Program Expo Day Agenda

3. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Lausanne Chemin de Roseneck 5 1006 Lausanne, Switzerland +41 (0)21 552 0801 Zurich Technoparkstrasse 1, Transfer Nord 2023 8005 Zürich, Switzerland +41 78 621 87 87 San Francisco 1161 Mission St. Office 434 San Francisco, CA 94103 +1 (415) 781-5000 MindMotion™ Products: a series of medical-grade virtual reality solutions for neurorehabilitation Daniel Perez-Marcos, Dr.-Ing.

5. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland 16.9 million strokes per year worldwide ~4.4M stroke survivors have motor disabilities; incidence is growing at 5%/year ~45% require chronic home rehabilitation 10B$ Neurorehabilitation costs in US & EU Loss of Function after Stroke

6. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Rehabilitation Objectives The ultimate goal of the rehabilitation is to become independent. Rehabilitation should include functional, activity and social levels -WHO

7. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Time is Brain Time window of recovery • Recovery of motor function has been observed to be most rapid during the first month after stroke 1 • Ability to recover is highest within first 15 days post stroke 2 However… • Stroke onset to rehabilitation admission interval is 17 days in average 3 1 Lee et al. 2015 2 Salter, Rehabil Med 2006 3 Roth and Lovell, PM&R 2009 Modified from Ward et al., ACNR 2015;15(4):6-8

8. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Rehabilitation Dose & Intensity • NICE guidelines call for 45 min of upper limb rehab per day 1 • Only 9% of hospital units meet guidelines target for physiotherapy 2 • Patients spend 48.1% of the day inactive 3 • Hospitalized patients spend 57% of their time alone in their bedrooms 4 1 NICE Guidance – Stroke (QS2) 2010 2 UK Sentinel Stroke National Audit Programme, 2015 3 Bernhardt et al., Stroke 2004 4 West & Bernhardt, Stroke Res & Treatm 2012 Guidelines vs. “Real World” Training Time Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland

9. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland MindMaze’s Continuum of Care The MindMotion™ Series Hospitals Rehabilitation Centers (Inpatient) Outpatient Rehabilitation Home ACUTE SUBACUTE CHRONIC

10. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Virtual Reality for Neurorehab • Personalize medicine • Motor and cognitive processes • Ecological & intensive training • Multisensory feedback • Real-time rewards • Enhance motivation

11. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland 11 MINDMOTION™ PRO Hospital-based solution for early upper limb rehabilitation 3D Motion Tracking Camera Patient Screen for VR-based exercises Touch Screen Rehabilitation sessions assigned, stored & interrogated Mobile platform Adapted to bedside use

12. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Virtual Reality based Upper LimbNeurorehabilitation Integrated therapy Constraint-induced therapy Mirror therapy Action observation therapy Motor imagery Interactive & immersive exercises Increase motivation & therapy dosage

13. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Rehabilitation is a Very Long Process • Improvement in chronic stroke through intensive training is possible 1 • “Plateau” of recovery is accentuated by constraints or reduction in rehabilitation services 2 1 Page et al., Arch Phys Med & Rehab 2004 2 Demain et al., Disability & Rehab 2006 Recovery continues for months & even years after an initial, rapid recovery period (Michaelsen at al., 2006; Wilson, 2010; Nudo,2003, 2013)

14. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland MindMaze’s Continuum of Care The MindMotion™ Series MindMotion™ PRO MindMotion™ GO ACUTE SUBACUTE CHRONIC Hospitals Rehabilitation Centers (Inpatient) Outpatient Rehabilitation Home

15. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland The Value of MindMotion™GO  Helps increase training dose  Enhances patient’s motivation  Makes the therapy fun  Tracks progress over time in context of therapeutic goals  Helps escape from the disease  Enhances re-learning process  Provides stimulating environment (problem solving)  Allows treating more patients  Increases therapy adherence

17. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland MindMaze’s Continuum of Care The MindMotion™ Series ACUTE SUBACUTE Track patient journey - eCRF Data collection from the MindMotion™platform MindMotion™ PRO MindMotion™ GO CHRONIC Hospitals Rehabilitation Centers (Inpatient) Outpatient Rehabilitation Home MindMotion™ HOME

18. Copyright 2016, All Rights Reserved – MindMaze SA Lausanne, Switzerland Lausanne Chemin de Roseneck 5 1006 Lausanne, Switzerland +41 (0)21 552 0801 Zurich Technoparkstrasse 1 Transfer Nord 2023 8005 Zürich, Switzerland +41 (0)78 621 87 87 San Francisco 535 Mission Street 14th Floor San Francisco, CA 94105 U.S.A +1 (415) 781-5000 info@mindmaze.com www.mindmaze.com Thank You!

19. The State of Brain Health Innovation Alvaro Fernandez SharpBrains’ CEO & Editor-in-Chief December 8th, 2016

20. Next, Portuguese!

21. THE DEMAND

22. THE SUPPLY

23. THE SCIENCE

24. ① Lifelong neurogenesis and neuroplasticity ② 2010 NIH evidence review ③ Digital toolkit

25. Source: The SharpBrains Guide to Brain Fitness (second edition)

26. “Be the change you want to see in the world” “The best way to predict the future is to invent it” @alvarof alvaro@sharpbrains.com

27. SARPBRAINS VIRTUAL SUMMIT DECEMBER 8, 2016 41 Mark Watson, Director, Watson Centre For Brain Health

28. CURRENT PARADIGM IN TBI RECOVERY Majority of mild cases recover cognitive functions (http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm) Moderate cases do not and neither do more complicated mild cases What do we do with cases that do not recover. Currently most seem to employ compensatory programs to steer around under performing networks Challenge this and perhaps improve it through Capacity building: Cognitive rehabilitation therapy (CRT) is a strategy aimed at helping individuals regain their normal brain function through an individualized training program. Using this strategy, people may also learn compensatory strategies for coping with persistent deficiencies involving memory, problem solving, and the thinking skills to get things done. CRT programs tend to be highly individualized and their success varies. A 2011 Institute of Medicine report concluded that cognitive rehabilitation interventions need to be developed and assessed more thoroughly. (http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm) Neuroplasticity = brain change In learning disabilities the Arrowsmith Program has experienced great results in increasing cognitive capacities for students with cognitive dysfunctions WCBH 2016 42 WCBH BEGINS FALL OF 2013 WHILE AT U OF T’S NEURO REHAB CONFERENCE

29. WCBH 2016 43

30. A PROBLEM PEOPLE WITH TBI & ABI POST ACUTE CARE PHASE Current Once past acute stage What long term care is provided? How much? Why/why not? What value could would be associated if planning, organizational and memory function could be regained following injury? WCBH Capacity building cognitive rehabilitation Desires to treat cognitive symptoms WCBH 2016 44

31. AN INTRODUCTION TO THE WATSON CENTRE FOR BRAIN HEALTH: The Watson Centre for Brain Health’s mission is simple: to improve the lives of people that have suffered a brain injury and/or concussion by implementing programs aimed at increasing capacities so that our clients will have the ability to live more productive and independent lives. WCBH 2016

32. OUR PROGRAM- (AP) 37 YRS. OF EXPERIENCE IN LEARNING DISABILITIES 1. Individualized cognitive testing (AP) 2. Baseline testing results inform individualized program design. 3. 4-5 days per week 3-3.5 hrs per day 4. Real time data analysis & goal setting (intrinsic) 5. Baseline and 9 month internal program testing to determine progress 6. Qualitative self report 7. Real time Health Tracking using WCBH 2016 46

33. LONG TERM REPORTED COGNITIVE IMPACT OF BRAIN INJURY HTTP://WWW.TRAUMATICBRAININJURY.NET/FAQS/ Problem solving Attention and/or executive funtioning Learning, both using old information and learning new information Memory loss

34. SELF-REPORTED IMPOVEMENTS QUALITATIVE FROM WCBH PARTICIPANTS (AT 6 MONTH MARK) Clearer thinkin g Increase d memory & memory for details Increased executive functionin g/attentio n More outgoing and talkative Increased understandi ng in real time REPORTED FINDINGS WCBH, 2015 48

35. PRINCIPAL INVESTIGATOR’S STATEMENT Dr. Nazrin Virji-Babul,UBC : “The most important thing we have learned from the pilot project using the Arrowsmith intervention/Watson Centre Program is that the brain has an incredible capacity to change. What we have seen – even with a small group of participants – many of whom who had a chronic brain injury – is that intervention/stimulation can make a change in the brain and in cognitive/behavioural function. We still have lots to learn about how to best target intervention and many questions to answer about the amount and type of intervention that can lead to most optimal recovery.” MORE RESEARCH NEEDS TO BE DONE. WCBH 2016 49

36. WATSON CENTRE: SHAPE OF THE DAY Morning and Afternoon options 3.5 hour program 4 Arrowsmith Cognitive activities (35 minutes each) 1 Exercise period (35 minutes) 1 Nutrition Break (15 minutes) 1 Meditation period (10 minutes) Assessment of fit: Our program is for people with ABI 1-2 years post injury Participant must meet with our team to assess their ability to engage in this program . Program Costs: • $14,225 for 6-month program (January 2017 to June 2017) • $9,800 for the first 3-month program and then $7,900 for each subsequent 3-month program (the full programming is assessment not necessary after the initial program). We do currently accept MEDICARD from ifinance for program financing for clients in order to increase accessibility

37. VISION FOR THE FUTURE A world where anyone can return some lost cognitive function after an injury or illness… Less stigma surrounding brain injuries Better understanding of how brains can recover from injuries and illnesses More treatment options with increased accessibility to them Learn more: www.watsonbrainhealth.com CONTACT: MWATSON@WATSONBRAINHEALTH.COM

38. Q&A

39. Thank you to all Participants!

40. Sponsors Thank you to all Speakers & Sponsors!

41. To learn more, visit sharpbrains.com