The metabolic syndrome, a state of progressive metabolic dysfunction, injures the peripheral and central nervous systems, promoting peripheral neuropathy (PN) and cognitive impairment (CI), respectively. We posit PN and CI are connected in the metabolic syndrome framework, built on the premise that neurons, whether in the peripheral or central nervous systems, are susceptible to similar injury from shared metabolic risk factors and pathophysiological processes. We highlight future studies for determining the relative evolution of PN and CI in metabolic syndrome, and propose revising the "stocking-glove" description of PN to "stocking-glove-hat" encompassing CI, concluding with research, therapeutic, and clinical implications. ANN NEUROL 2026.

Artificial intelligence (AI) is becoming part of the working infrastructure of academic medicine. Because grants convert scientific ideas into protected time, infrastructure, and institutional priority, they provide a revealing test case for AI's effects on biomedicine. Five issues are emerging: language, agency, review, doership, and identity. AI can polish weak proposals, shift the origin of ideas, align proposal and review language around fundability, and create feasibility theater, projects that sound executable, but exceed a laboratory's capacity. The challenge is to keep AI anchored to lived expertise, the experience of failure, and the formative work by which faculty become scientists. ANN NEUROL 2026.