HOPE Therapeutics first to deploy Zeta Surgical's robotic TMS system
HOPE Therapeutics, the interventional psychiatry subsidiary of NRx Pharmaceuticals, has begun training its clinical team on Zeta Surgical's newly FDA-cleared Zeta TMS Robotic System. Staff are completing orientation at Zeta Surgical's Boston headquarters before the platform is rolled out across HOPE's Florida clinics, making HOPE the first commercial operator to deploy the robotic system following its FDA 510(k) clearance in July 2026.
The move builds on a step HOPE took earlier this year. In June 2026, the network became the first US commercial site to treat patients with Zeta's TMS Navigation System, an AI-driven image-guidance tool that tracks head position in real time and shows the clinician where the TMS coil sits relative to an MRI-derived brain target. The new robotic system takes that a stage further by mounting the coil in a robotic arm, originally approved for neurosurgery, which adjusts the coil position continuously with submillimetre precision. The practical benefit is that treatment accuracy is no longer contingent on the patient remaining perfectly still or a technician holding the coil in place manually.
SPARC-TMS and the military connection
The deployment is directly linked to SPARC-TMS, NRx's FDA-approved Phase 2/3 trial of NRX-101, an oral combination of D-cycloserine and lurasidone, delivered alongside robotic TMS. NRx said it has been selected by the Defense Advanced Research Projects Agency as prime contractor for a military arm of the trial, in partnership with Harvard McLean Hospital, subject to completion of contracting. The study, registered under NCT07227103, is planned across a US academic teaching hospital, multiple HOPE clinics, and two military treatment facilities.
Jonathan Javitt, chairman and chief executive of both NRx Pharmaceuticals and HOPE Therapeutics, said the system would deliver "neurosurgical-grade precision to every patient, in every session," and described it as the foundation for the company's goal of "measurable, rapid, and durable remission from depression."
NRX-101 holds FDA Breakthrough Therapy Designation for suicidal bipolar depression. The company is also developing NRX-100, a preservative-free intravenous ketamine formulation, which carries Fast Track Designation for suicidal ideation in depression.
Market context
Transcranial magnetic stimulation is a well-established non-invasive therapy for treatment-resistant depression, a condition that affects roughly one-third of patients with major depressive disorder. The TMS market has historically been dominated by a small number of device manufacturers, with clinical outcomes often criticised for variability in coil placement between sessions. Robotic and AI-guided delivery systems are an emerging attempt to address that reproducibility problem, and several academic centres have been exploring automated neuronavigation for some years.
HOPE's commercial rollout is notable because it frames TMS delivery as a proprietary clinical differentiator rather than a commodity service, a positioning that could prove significant if the SPARC-TMS trial generates compelling combined-modality data. The DARPA involvement also opens a funding stream that is largely insulated from the commercial capital markets on which clinical-stage NASDAQ-listed biotechs typically depend. Investors will be watching for a contracting announcement, an enrolment start date, and any interim readout from the SPARC-TMS protocol as near-term catalysts for NRx.