Robotic TMS for Depression and Where ABB Cobots Fit

Transcranial magnetic stimulation, or TMS, treats depression with magnetic pulses from a coil placed against the scalp. Usually a person holds that coil or clamps it in a passive holder. Robotic TMS hands the job to a robot arm that steers the coil to a target picked from the patient's brain scan and follows the head when it moves. In July 2026 the US FDA cleared the Zeta TMS Robotic System, and in October a DARPA-backed trial began testing robotic TMS delivered in a single day. This post covers the history from Anthony Barker's first devices in 1985 to today's robots, and where ABB cobots could fit.

Dr Anthony T. Barker, whose search for a painless alternative to electrical stimulation led to TMS, in 2015. Photo: Ctpls / Wikimedia Commons (CC BY-SA 4.0)

How TMS coils were aimed by hand

Doctors stimulated the brain with electricity long before they used magnets. Work on it started in the late 1800s, and by the 1930s the Italian physicians Cerletti and Bini had developed electroconvulsive therapy. In 1980 Merton and Morton stimulated the motor cortex with current passed through the skull, a method that hurt. Anthony T. Barker went looking for an alternative and turned to magnetic fields, and the first stable TMS devices appeared in 1985, built for diagnosis and research. The principle has not changed: a stimulator sends pulses to a coil on the scalp, and the field passes through the skull and induces a small current in the brain tissue below. Most devices use a coil shaped like a figure eight.

A Siemens Konvulsator III electroconvulsive therapy machine from about 1960. Photo: Nasko / Wikimedia Commons (CC0)

Aiming was manual. Operators placed the coil using anatomical landmarks on the skull, in particular the inion and the nasion, then held it or fixed it in a passive holder. The FDA classified the Neuronetics NeuroStar system as a Class II device for major depression in July 2011 and cleared Brainsway's deep TMS in January 2013. Holding a coil by hand for sessions longer than 30 minutes is hard to do well. Axilum Robotics cites studies showing that a coil rotation of 7 degrees can change stimulus intensity by 25 percent or more, and that with a passive holder the induced field can drop by 30 percent over 30 minutes.

A 3D printed guide, designed from MRI data, that holds a MagVenture TMS coil over both frontal lobes, 2020. Photo: Uriel83 / Wikimedia Commons (CC BY-SA 4.0)

Navigated systems took on the aiming problem. In December 2009 the Finnish company Nexstim got FDA clearance for its eXimia Navigated Brain Stimulation system, which maps the primary motor cortex for planning before a procedure. Robots came out of the same need. In 2004 Dr Jack Foucher of the INSERM research unit U666, a TMS pioneer in France, asked Professor Michel de Mathelin's medical robotics group at the University of Strasbourg for a way to automate stimulation, because some patients need up to 30 sessions and no robotic solution existed. That work led to Axilum Robotics' TMS-Robot, the first robot designed specifically for TMS.

A TMS laboratory, photographed on the set of the film The Brain: The Second Universe in 2017. Photo: Adindva1 / Wikimedia Commons (CC BY-SA 4.0)

Robotic TMS in clinics today

The newest system comes from Zeta Surgical. Its TMS Robotic System, cleared by the FDA on 10 July 2026 as a Class II stereotaxic instrument, positions the coil in real time with submillimetre accuracy, tracks the patient's head and moves the coil to stay on target. Zeta says it sets up in under a minute, and it tested accuracy and usability with Harvard Medical School and the University of Cambridge. Its companion navigation system registers a patient's MRI or CT scan to the face in under two minutes, and Florida-based HOPE Therapeutics already uses it in outpatient TMS for depression.

A figure-eight coil for transcranial magnetic stimulation, 2014. Photo: Baburov / Wikimedia Commons (CC BY-SA 4.0)

On 15 October 2026 Zeta announced a collaboration with DARPA on SPARC-TMS, a Phase 3 study of robotic, neuronavigated TMS given in a single outpatient day for severe depression, together with NRx Pharmaceuticals' investigational drug NRX-101. McLean Hospital, HOPE Therapeutics and Walter Reed National Military Medical Center take part. Zeta points out that conventional TMS means repeated visits over several weeks and leans on trained operators. Faster schedules are spreading anyway: UC Davis Health now offers SAINT, with ten sessions a day for five days at targets personalised from fMRI, instead of one session a day for six weeks or more.

A 1.5 tesla MRI scanner with its patient table. Personalised TMS targets are planned from scans like these. Photo: Sergei.Verzilin / Wikimedia Commons (CC BY-SA 4.0)

We found no ABB robot in a TMS system. Still, the job asks for things ABB's GoFa CRB 15000 is built around. ABB says GoFa limits power and force with torque sensors in its joints, has a rounded design without pinch points and is safety certified to Category 3, PL d. Its Ultra Accuracy option gives a path accuracy down to 0.03 mm and an absolute position accuracy of 0.1 mm, and the arm can be taught by moving it by hand.

Moving an ABB GoFa CRB 15000 by hand. Torque sensors in each joint let it feel contact. Photo: ABB

Where robotic TMS goes next

Robots are being sold on shorter courses that need fewer specialists. Zeta says its robotic neuronavigation is designed to cut both the time and the specialised staff needed for precise TMS, so it could be offered where expert clinicians are scarce. For patients and families that could mean a week of treatment, or one day if the DARPA trial works, instead of six weeks of daily trips. TMS is also used for obsessive-compulsive disorder, PTSD and addiction, so robotic positioning may spread beyond depression. Axilum's robots are already in use from UCLA Health to Avive Health in Brisbane. ABB, for its part, runs a Life Sciences and Healthcare Lab at the Texas Medical Center campus in Houston.

A GoFa cobot at ABB's healthcare research hub. Photo: ABB

No ABB-based TMS arm exists, so this part is a possibility. A GoFa would need a coil mount, a tracking camera and neuronavigation software, the way Axilum pairs its cobot with Brainsight and LOCALITE navigators, plus clearance as a medical device, as Zeta's and Axilum's systems have. The positioning paths could be planned and checked offline in RobotStudio first. Similar questions come up in our posts on MRI-guided robots and rehabilitation robots, where an arm also works right next to a patient.

An engineer with a GoFa cobot, the arm ABB offers with its Ultra Accuracy option. Photo: ABB

The evidence is still mixed. Study quality varies, effect sizes are modest and placebo responses are large, so better targeting has to prove that it improves results. Serious side effects are rare: fainting and seizures occur in roughly 0.1 percent of patients and are usually traced to administration errors. Insurance has been patchy too: in 2013 several US insurers covered TMS for depression for the first time, while UnitedHealthcare said the evidence was insufficient. A robot also adds setup work and another machine to maintain, so clinics will need staff who understand both the psychiatry and the machine.

A TMS setup with the coil held against the head by a mechanical arm, 2015. Photo: Baburov / Wikimedia Commons (CC BY-SA 4.0)

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