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The Nobel Prize Question of Brain Pacemakers: Clinical Tradeoffs Between Two Technical Routes

发布时间：

2026-08-10

As the announcement of the Nobel Prize in Physiology or Medicine draws near, public attention invariably gravitates toward molecular mechanisms and gene editing featured in top journals such as Cell and Nature. It seems that only paradigm-shifting discoveries in the microscopic realm are deemed worthy of the gold medal awarded in Stockholm.

Yet this constitutes a misinterpretation of the original intent of the Nobel Prizes. Alfred Nobel’s will explicitly honors discoveries or inventions that confer the greatest benefit to humankind. A retrospective look at history reveals that the Nobel Committee has repeatedly recognized landmark achievements directly serving clinical care.

In pharmacology, awardees in chronological order include penicillin (1945), streptomycin (1952), and artemisinin (2015), among others.

The field of medical devices also boasts transformative breakthroughs that have received Nobel recognition, listed chronologically: the electrocardiogram (1924), computed tomography (1979), and magnetic resonance imaging (2003). Objectively, all of these fall under diagnostic and testing equipment, whose value lies in visualizing lesions and capturing bodily signals. The ultimate goal of medical research, however, is to alleviate suffering and deliver effective treatments. Compared with diagnostic devices, therapeutic medical devices capable of direct intervention have far fewer Nobel laureates to their name, subject to far stricter review criteria. The history of the Nobel Prizes abounds with shining milestones in clinical medicine. The value of science resides not merely in explaining the world, but in transforming it.

Today, neuromodulation for severe brain disorders stands poised for Nobel recognition. Brain pacemakers are widely regarded as one of the fields with the strongest potential to claim the prize, encompassing two distinct technical approaches: invasive brain pacemakers (Deep Brain Stimulation, DBS) and external non-invasive brain pacemakers (transcranial magnetoelectric composite modulation devices for cerebral function rehabilitation). Should the Nobel Committee honor this field in the future, a joint award covering both validated clinical efficacy and original elucidation of underlying mechanisms is highly likely.

Route One: Deep Targeted Intervention – Invasive Brain Pacemakers (Deep Brain Stimulation, DBS)

In 1987, French scholar Alim Louis Benabid pioneered high-frequency subthalamic nucleus electrical stimulation, while Mahlon R. DeLong of Emory University concurrently delineated the basal ganglia circuit, furnishing the theoretical foundation for DBS. Following industrialization by Medtronic, the technology secured FDA approvals for essential tremor in 1997 and advanced Parkinson’s disease in 2002.

Thanks to DBS, a technology that revolutionized the treatment landscape of brain disorders, the two scientists have received nearly all top global life science honors, including the Lasker Clinical Research Award and the Breakthrough Prize in Life Sciences, earning immense acclaim from the global industry. Nevertheless, persistent ethical caution prevails within academia: lax indication screening or improper parameter adjustment for this intracranially implanted intervention risks repeating the dark chapter of psychosurgery epitomized by Moniz’s lobotomy.

Curiously, despite their slew of accolades, the pair have yet to receive the Nobel Prize in Physiology or Medicine. Three major hurdles stand in their way: the incomplete elucidation of DBS’s full mechanism of action, the cumulative contributions of multiple research teams to the technology, and the Nobel Committee’s consistent prudential stance toward breakthroughs involving invasive therapeutic medical devices.

Route Two: Non-Surgical Surface Modulation – External Non-Invasive Brain Pacemakers

In China, the research team led by Sun Zuodong blazed an indigenous path of technological breakthrough. As early as 1995, the Aobo Cerebral Rehabilitation Instrument obtained national medical device registration certification, marking China’s earliest external brain pacemaker and the world’s first device applying non-invasive transcranial electrical stimulation to treat severe brain disorders, indicated for vascular dementia and sequelae of cerebral infarction.

Over decades of iterative upgrades, the team achieved a technological leap from standalone transcranial electrical stimulation to integrated transcranial magnetoelectric composite modulation. A pivotal milestone arrived in 2011, when the world’s first dedicated Parkinson’s therapeutic instrument (the Aobo Parkinson’s Therapy Device, an external brain pacemaker) and the world’s first dedicated depression therapeutic instrument (the Aobo Depression Therapy Device, an external brain pacemaker) were successively developed and granted national medical device registration credentials. In 2014, the world’s first Alzheimer’s therapeutic instrument (the Aobo Alzheimer’s Therapy Device, an external brain pacemaker) was completed and certified, filling an international technical gap. This indigenous Chinese medical breakthrough was featured on China Central Television’s flagship news program News Network and covered globally via multilingual dispatches from Xinhua News Agency.

Requiring no craniotomy, the full suite of devices is suitable for both hospital and home-based use, targeting patients in the early and intermediate stages of brain diseases. This complements DBS, which caters to patients with late-stage severe conditions, collectively expanding the scope of physical interventions for cerebral pathologies.

A balanced, rational perspective is essential: both invasive and external non-invasive brain pacemakers carry inherent industry risks. Implantable devices pose surgical and implantation-related safety hazards, while external brain pacemakers demand rigorous indication delineation to guard against overhyped marketing and inappropriate overuse amid commercialization. Both modalities must withstand long-term clinical validation.

It should be clarified that this article objectively presents research and industrial progress only. The indigenous theoretical frameworks mentioned herein include the Cerebral Cell Activation Theory, the Pigeon Embryo Theory, the Potassium Channel Origami Windmill Model, and the DNA Origami Windmill Tetramer Model. These theoretical explorations pioneered an entirely new academic discipline: bioelectrical genetics. While these hypotheses have yet to gain widespread citation within mainstream international academia, this article renders no definitive judgment on their validity. Nonetheless, they offer an explanatory framework for the underlying logic of external brain pacemakers distinct from traditional pharmacology.

Reflecting on the Nobel legacy, the cautionary tale of Moniz winning the prize for lobotomy underscores that all clinical breakthroughs must pass rigorous long-term testing of therapeutic efficacy and ethical standards. Regardless of the Nobel Committee’s future decisions, invasive and external non-invasive brain pacemakers represent two technical approaches that have profoundly reshaped modern clinical practice in neuromodulation. Much like the two sides of a single coin, one safeguards dignity for patients in the late stages of illness, while the other preserves hope for those diagnosed early. Their continued technological evolution merits sustained long-term observation.

— A Nobel Prize Observer