The successful launch of China’s prospective clinical trial for invasive brain-computer interfaces, alongside the U.S. Food and Drug Administration (FDA)’s approval of the first closed-loop deep brain stimulation (DBS) system, marks the accelerating integration of electric medicine into clinical settings[
1,
2]. Characterized by microampere-scale currents, millisecond-duration pulses, and nanoscale-resolution electrodes, electric medicine represents a paradigm shift: it moves beyond conventional pharmaceuticals that target molecular pathways to electroceuticals that operate at the level of neuronal signaling, enabling precise modulation of neural activity with spatial and temporal resolution unattainable by chemical agents.
The concept of regulating physiological functions through electrical signals has a long history. In the 18th century, Italian physiologist Luigi Galvani’s iconic “frog leg experiment” revealed that electrical stimulation could induce muscle contraction, thereby uncovering the fundamental role of bioelectrical activity in biological signaling. Two centuries later, DBS was applied to the treatment of Parkinson’s disease, which for the first time proved that precise electrical pulses could effectively regulate abnormal neural circuits[
3]. Since then, electroceuticals have advanced in sophistication and expanded in application scope, evolving into a diverse intervention system centered on neuronal signaling. This system includes intracranial interventions like DBS, transcranial magnetic stimulation that target neural activity within the brain[
4,
5]; spinal cord interventions such as spinal cord stimulation designed to modulate spinal neural pathways[
6]; and peripheral nerve interventions encompassing functional electrical stimulation, vagus nerve stimulation, and sacral neuromodulation outside of central nervous system[
7–
9].
Driven by advances in neuroanatomical mapping, implantable biocompatible devices, and artificial intelligence, electric medicine has entered a critical stage of precision and intelligence. At the level of neural circuit engineering, the cross-hierarchical regulation system centered on electrical signals has achieved a leap from theory to clinical translation. The brain-spinal interface (BSI) technology developed by Dr. Courtine in Switzerland records and decodes motor intentions through a brain-computer interface, then delivers spatiotemporal electrical stimulation to the spinal cord in real time to trigger leg muscle activity, enabling paralyzed patients to achieve volitional movement through mind control[
10]. Multi-modal electrophysiological monitoring is essential for achieving biofeedback, encompassing electrical signals such as local field potentials (LFP), electroencephalography (EEG), and surface electromyography (sEMG). The advancement of multimodal electrophysiological monitoring technologies, together with the continuous evolution of artificial intelligence, has significantly improved signal accuracy and processing speed. In turn, this provides a key technological driving force for the transformation of electrical stimulation therapies—from fixed stimulation paradigms to on-demand precise modulation, and further from single-mode stimulation to closed-loop intelligent regulation.
Global initiatives including the U.S. DARPA ElectRx program, the NIH SPARC project, and the “Brain Protection and Regulation” direction in China’s Brain Program all prioritize precise electrical stimulation and neural interface systems as strategic goals, representing a shift from a pharmaceutical model which rely on chemical molecules to electroceutical based on neuromodulation. By modulating endogenous neural signaling, electric medicine offers inherent advantages over traditional drugs, including specificity, precision, reversibility, and real-time adaptability.
Despite these advancements, electric medicine still faces key challenges that require breakthroughs: a systematic understanding of the electrophysiological patterns of neural circuits remains elusive; in addition, validated biomarkers to guide real-time adjustments in closed-loop systems are still under development. Future progress will depend on the deep integration of neuroscience, materials science, clinical rehabilitation engineering, and artificial intelligence. Driven by interdisciplinary collaboration, these once lab-simulated electrical pulses are poised to emerge as novel “drugs”—restoring neural function, reconstructing motor abilities, and treating multi-organ diseases—thereby redefining the paradigm of modern healthcare.
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