NeuroStar devices require a cloud connection and per-treatment fees to operate — even after clinics pay up to $80K for the hardware. We're building the open-source server that gives clinics device independence.
TMS is an FDA-cleared, non-invasive brain stimulation therapy that helps people when antidepressants haven't worked. No surgery. No anesthesia. No systemic side effects.
An electromagnetic coil placed against the scalp delivers focused magnetic pulses to the left dorsolateral prefrontal cortex — the brain region involved in mood regulation. These pulses stimulate underactive neurons, gradually restoring normal activity patterns.
Patients sit in a chair for 19–37 minutes per session, 5 days a week, for 6–7 weeks (36 sessions total). They're fully awake the entire time. Most describe a tapping sensation on the scalp. There's no recovery time — patients drive themselves home.
Major depressive disorder (NeuroStar, 2008), anxious depression (NeuroStar, 2021), adolescent depression (NeuroStar, 2024), OCD (BrainsWay Deep TMS, 2018), smoking cessation (BrainsWay, 2020), and migraine (investigational). Over 7.6 million treatments delivered to date across the NeuroStar platform alone.
The most common side effect is mild scalp discomfort during treatment, which typically resolves within the first week. Serious adverse events are rare (<0.1%). TMS does not cause the weight gain, sexual dysfunction, or cognitive dulling associated with many antidepressants.
The right-to-repair movement has shown what happens when manufacturers retain control over hardware customers have already paid for. The same pattern exists in medical devices — with higher human stakes.
The NeuroStar requires an active TrakStar cloud connection to operate. Neuronetics' Terms of Sale confirm TrakStar is licensed, not sold, and tied to the system's service term. If that connection is lost — for any reason — so is the clinic's ability to treat patients.
After paying up to $80K for the machine, clinics pay $60–$100 per treatment for the life of the device. Neuronetics' SEC filings show per-treatment fees were ~70% of their U.S. revenue. These ongoing costs make it harder for independent and underserved clinics to offer TMS at accessible prices.
What happens when cloud support ends? The Terms of Sale contain no offline-mode guarantee. No legacy mode is documented. Clinics and patients deserve to know that a device they rely on won't become unusable if a company changes its business model.
TMS is one of the most effective treatments for depression that doesn't respond to medication. But the cost structure means most eligible patients never receive it.
The per-treatment fee is charged on top of the machine purchase (up to $80K new). It never stops. It can never be paid off.
The NeuroStar connects to trakstarcloud.com over HTTPS. We redirect that DNS entry to a local server that speaks the exact same API. The device doesn't know the difference.
We never touch the device software. The machine boots normally, connects to what it thinks is Neuronetics' server, and operates exactly as designed. All treatment safety logic stays on the device.
Our server validates every treatment parameter against 8 FDA-cleared protocols. Max 50Hz frequency, 120% motor threshold, 4000 pulses per train. We refuse unsafe parameters even if someone tries to send them.
A Raspberry Pi. An old laptop. Docker. Any machine on your clinic's network. No special hardware, no cloud dependency, no subscription. You own your server like you own your machine.
All patient records, treatment histories, motor thresholds, and clinical notes stay on your local server. No PHI leaves your network. Full HIPAA control without a third-party cloud.
Every line of code is backed by tests. Every API route matches the spec. This isn't a hack — it's a carefully built, spec-compliant replacement server.
Through reverse engineering, patent analysis, FDA filings, and live API probing, we've mapped the entire NeuroStar ecosystem.
The NeuroStar's brain is an Intel Atom Bay Trail SBC with a CompactFlash boot slot. We can image the firmware with a $10 CF card reader. eBay has CPU+firmware bundles for ~$3K.
Discovered via 510(k) K231926 cross-reference. The software stack is .NET on Windows Embedded, with ServiceStack 6.x powering the API. Every endpoint uses camelCase JSON with lowercase error envelopes.
From the original 2008 De Novo classification through the 2024 adolescent clearance. We've identified 27 patents covering every subsystem, with US8177702 (contact sensing) as the architectural Rosetta Stone.
The Liberation Server runs on your own network with no external cloud dependencies. All authentication, rate limiting, and treatment safety limits are enforced locally — eliminating exposure to upstream vendor infrastructure risks.
Avalue (Taiwan) makes the SBC. Molex makes the SenStar contact sensor. Ascential Technologies assembles the console. Gharieni builds the chair. We know who makes every component.
Here's what happens when you eliminate the per-treatment vendor fee for a single NeuroStar machine.
The software is 80% ready. To reach 100%, we need a used NeuroStar console to extract the firmware, capture the final authentication handshake, and validate the server end-to-end against real hardware.
Complete system unit from eBay with CPU board (Avalue ECM-BYT) and CompactFlash firmware card. This is the single item that closes every remaining gap — firmware extraction, live auth handshake capture, and end-to-end server validation.
Everything needed to capture, decode, and analyze the device-to-cloud communication during live operation.
Board-level diagnostic tools and consumables for safe hardware analysis and end-to-end treatment simulation.
More options and anonymous donations on the full donate page.
Every aspect of this project operates within established legal frameworks for medical device repair and interoperability.
Permits reverse engineering for interoperability. We are creating a compatible server, not bypassing copy protection.
Medical device repair exemption renewed by the Copyright Office. Explicitly permits circumvention for maintenance and repair of medical devices.
Cybersecurity transparency requirements. Device manufacturers must provide documentation sufficient for third-party security assessment and maintenance.
Prohibits manufacturers from conditioning warranty coverage on use of branded parts or authorized service, unless provided free or with an FTC waiver. The manufacturer must prove third-party service caused a defect to deny a claim.
Released as free, open-source software under the MIT license. Any clinic, anywhere, can use it. No subscriptions. No telemetry. No strings.
The server, deployment scripts, test suite, protocol library, and documentation are all public. Fork it, audit it, improve it.
Step-by-step instructions for Linux, macOS, Docker, and Raspberry Pi. DNS configuration, TLS certificate generation, systemd service files. A non-technical clinic admin can set it up.
No registration. No API keys. No analytics. You download it, you run it, you own it. The way software used to work. The way medical equipment should work.
Once released, the community maintains it. If I get hit by a bus tomorrow, the code doesn't die with me. That's the point of open source — no single point of failure.
The software is 80% ready. The last 20% requires a used NeuroStar console to extract firmware and validate end-to-end. $4,500 gets us to full device independence.
More options and anonymous donations on the full donate page. If you have a NeuroStar machine, that's worth more than money.