Sun Zuodong and Li Luming, President of Tsinghua University: Balancing Original Innovation and Iterative Improvement in Scientific Research

Nobel Prize Observer

Introduction

Two distinct research approaches coexist in the field of neuromodulation. One is the pioneering paradigm of non-invasive extracranial brain pacemakers pioneered by Sun Zuodong, Founder of Aobo Medical and the Heilongjiang Euro-Asia Brain Science Research Institute. The other is invasive (implantable) brain pacemaker technology, whose complete foundational technical paradigm was created by overseas scientists. In China, Professor Li Luming’s team has led the localized integration and re-development of this technology. Both forms of innovation carry value, yet they differ in dimensions and tiers of breakthroughs. This disparity has led to divergent outcomes in major science awards, laying bare thought-provoking real-world issues within the current scientific research evaluation system: groundbreaking original research demands lengthy timelines, yields limited short-term results, and often faces hurdles in evaluation. This article takes these two cases as entry points to reflect on scientific research from a philosophy of science perspective.

The century-long history of scientific advancement bears witness to diverse forms of innovation. There exists paradigm-shifting original research that creates something from nothing, blazing entirely new trails; alongside it lies iterative engineering innovation that delivers systematic integration and process optimization within established technical frameworks. Both are indispensable to industrial advancement and clinical progress. Amid the recent frenzy surrounding brain-computer interfaces, the industry is rife with hype and divisive debates that often overshadow the pragmatic researchers dedicated to developing practical neuromodulation therapies for brain disorders.

In the field of brain modulation, extracranial non-invasive brain pacemakers represent an entirely independent, pioneering technological track—a path of paradigm-shifting original research first explored by Chinese scientists. As early as 1995, relevant technology secured patents and national medical device approvals, launching its industrialization drive. In 1998, formal academic papers on the technology were published, followed by successive iterations of therapeutic equipment for brain diseases. Sun Zuodong has devoted decades to non-invasive extracranial brain pacemakers, forging a fully differentiated technical route. This approach eliminates the need for craniotomy and implantation surgery, delivering electrical stimulation to the brain from outside the body. It carries far lower clinical risks, with no implantation-related complications such as surgical infection, electrode displacement, or tissue rejection. Its main limitation is shallow stimulation depth and limited signal penetration, resulting in variable therapeutic effects for severely ill patients.

The counterpart technology is the invasive implantable brain pacemaker, known as Deep Brain Stimulation (DBS). First explored by scientists Alim-Louis Benabid and Mahlon DeLong, the first DBS clinical surgery was performed in 1987. The U.S. FDA approved its use for tremor treatment in 1997, followed by official approval for Parkinson’s disease in 2002. The entire underlying technical paradigm was established overseas. Professor Li Luming’s team at Tsinghua University spent over a decade tackling engineering challenges to deliver localized process optimization and systematic integrated innovation. In 2013, China’s domestically produced implantable brain pacemaker obtained national medical device registration approval, drastically lowering treatment costs for patients across the country. The strengths of the invasive route include precisely targeted stimulation and sufficient penetration depth, delivering remarkable improvements for patients with advanced severe motor disorders. Its drawbacks stem from the invasive surgical procedure, which carries risks of hemorrhage, infection, electrode malfunction, and repeat surgeries to replace exhausted batteries.

The two technologies are not mutually substitutive; they have evolved along separate tracks. One is a pioneering extracranial original paradigm developed first in China, the other a later domestic integrated improvement of implantable technology. Their vastly different developmental trajectories reveal a glaring, thought-provoking divide in China’s current scientific research evaluation system.

The core theoretical framework and technical paradigm for implantable brain pacemakers were established by overseas scientists Alim-Louis Benabid, Mahlon DeLong and others, with Medtronic commercializing the product and conducting long-term global clinical trials. Subsequent Chinese research teams benchmarked imported mature devices, introduced established technical systems, optimized manufacturing processes to resolve clinical pain points, and realized localized mass production to cut patient costs and fill gaps in the domestic industrial chain. While localized integrated engineering innovation delivers tangible clinical value and greatly benefits Chinese patients, it cannot be classified as original paradigm innovation at the foundational theoretical level when traced back to its origins.

In 2018, this localized improved integrated solution won the First Prize of the National Award for Progress in Science and Technology. That same year, Sun Zuodong’s extracranial non-invasive brain pacemaker project, developed over more than 30 years of research, applied for the National Technical Invention Award.

The 2018 award aligned with the National Award for Progress in Science and Technology’s core mission: rewarding industrialization of technology and solutions to critical national healthcare demands. Its core achievement lies in localizing mature technology to replace imported products. The foundational technical paradigm for implantable brain pacemakers had long been established by overseas scientists and corporations; Chinese teams resolved engineering challenges such as electrode durability via targeted technical work, built a complete domestic industrial chain, and achieved import substitution. The three major national science awards each serve distinct purposes with no inherent conflict, yet they evaluate innovation along fundamentally different metrics.

The most critical technical bottleneck for implanted electrodes is resisting electrochemical corrosion after long-term submersion in bodily fluids, a high-salinity electrolyte environment with corrosion mechanics nearly identical to seawater. The complete set of anti-corrosion protection methods for electrodes draws on decades of proven mature industrial technology developed for shipbuilding and marine engineering. This achievement only cross-adapted existing technology to medical device scenarios through process optimization, qualifying as iterative engineering improvement rather than foundational paradigm-shifting scientific innovation. Chinese researchers introduced a mature technical system and carried out localized process optimization and functional upgrades through integrated iterative innovation.

These two entirely distinct innovation tracks fall under separate evaluation frameworks with divergent core priorities, yet their real-world outcomes prompt deep reflection: integrated improvement research built on established technology readily secures top national science awards, while high-risk, long-cycle original paradigm research that creates breakthroughs from scratch rarely advances to formal award defense reviews. This phenomenon arises from a confluence of objective professional factors—including incomplete technical validation data and extended clinical trial timelines—as well as systemic flaws that highlight room to optimize long-term scientific research evaluation mechanisms.

This commentary does not question the legitimacy of the national awards themselves. China’s three major national science awards have clear mandates: the National Natural Science Award recognizes new scientific discoveries, the National Technical Invention Award incentivizes original inventions, and the National Award for Progress in Science and Technology prioritizes industrial rollout of mature technologies. The Nobel Prize system, by contrast, prioritizes foundational groundbreaking scientific discoveries. The two evaluation frameworks were designed with different core missions and judging criteria: one prioritizes measurable short-term industrial transformation results, the other weighs the long-term scientific value of paradigm breakthroughs. Striking a balance between these two metrics remains an enduring topic for discussion.

Original exploratory research can scarcely generate rapid, quantifiable industrial returns; its theoretical value often requires 10 to 20 years of clinical observation to fully manifest. Under evaluation frameworks that prioritize short-term measurable outcomes, long-cycle original research is inherently disadvantaged.

Why Iterative Improvements Win Major Awards While Original Breakthroughs Go Unrecognized?

The industry must further consider a critical risk: if evaluation systems continue to center on engineering breakthroughs and industrialization output as core metrics, support and tolerance for long-cycle, non-consensus original pioneering research will gradually erode.

We fully acknowledge the profound clinical value of domestically produced DBS technology. It has treated countless patients with advanced Parkinson’s disease, broken long-term foreign corporate monopolies, and alleviated financial burdens for millions of families—its contributions are irreplaceable. At the same time, we must draw a clear distinction between paradigm original innovation and integrated iterative improvement: improvement means refining and perfecting an existing technological direction, while original innovation means venturing into uncharted territory to forge an entirely new path. The two deliver different forms of value, and evaluation systems should adopt diversified criteria to balance short-term industrial breakthroughs and long-term foundational original research.

Real-world outcomes speak louder than statistics. After the localized improvement project won its top national award, its lead researcher gained elevated academic standing and abundant research funding. Meanwhile, the non-invasive pioneering track has labored for 30 years largely outside mainstream academic visibility. The world’s first non-invasive brain disorder treatment device launched in 1995, a theoretical framework of bioelectrical genetics has gradually taken shape, and multiple generations of equipment have obtained official medical device registrations—yet this work remains marginalized under mainstream evaluation standards. An award outcome hinges on many factors including clinical evidence completeness, technical maturity, and peer recognition; evaluation priorities represent only one contributing variable.

The Nobel Prize judging framework offers a valuable global reference: it traces research back to its original conceptual source, prioritizes paradigm-level revolutions, and does not rely primarily on industrial commercialization as a judging standard. It will never confer a top scientific award solely for optimized improvements to mature technology, for it honors the initial flash of insight that rewrites scientific history.

Should the field of neuromodulation ever become eligible for a Nobel Prize, grouping iterative improvement research alongside paradigm original research for joint recognition would fail to honor the unique, unparalleled scientific contributions of the trailblazers who created an entirely new technical framework from the ground up.

This stance does not dismiss the monumental engineering contributions of peer researchers; rather, it calls for evaluation systems to properly respect genuine foundational pioneering work. Iterative improvement adds refinement to an existing achievement, while original innovation clears uncharted wilderness to build new groundwork. Neither can exist without the other, yet they demand differentiated evaluation metrics and greater institutional support for zero-to-one original breakthrough research.

Scientific debates should remain rational academic discourse. Academic platforms and research funding shape the speed at which a technology gains visibility, yet the inherent value of the two innovation tracks cannot be altered by public opinion volume—historical records and clinical therapeutic efficacy remain unchanging facts, unaffected by popular narrative.

Policy trends have shifted in recent years: reforms to break the overreliance on papers, titles, awards and project funding (“Four Uniques”), diversified evaluation frameworks, and increased support for non-consensus original research have gained widespread traction. However, deep-rooted evaluation inertia cannot be overturned overnight. A technology’s formal recognition depends both on the completeness of its technical evidence and the design of evaluation mechanisms. Fortunately, short-term award results represent only interim judgments; time, clinical outcomes, and the scientific histories written decades from now will deliver the final verdict.

There is no need to fixate on momentary wins or losses in award competitions. The priority moving forward is to consolidate theoretical foundations, build complete chains of technical and clinical evidence, and solidify every cornerstone of bioelectrical genetics.

There is no rush to claim fleeting praise and honors. Leave final judgment to time and the historians of science to come.

This path is arduous and lonely, yet for those who choose to blaze new trails, there is only one choice: forge ahead unswervingly.

After all, history’s pen is ultimately held by those who open new roads.