Cognitive Factors Research Articles

Exploring the relationship between cognition and mental health in intersex participants in the UK Biobank study

Objective: The physical and mental health of intersex individuals is woefully understudied. A recent survey of intersex individuals found high rates of self-reported cognitive issues such as difficulty remembering and concentrating as well as high rates of mental health issues, such as depression and anxiety. Method: The current study explores whether cognitive differences are observed between 353 intersex and over 400,000 non-intersex people using a latent model of cognitive tasks derived from measures in the UK (United Kingdom) Biobank study. Results: There were no differences in intelligence between intersex people and non-intersex people. We found significantly lower executive function and processing speed in intersex individuals versus non-intersex individuals. However, after accounting for mental health differences via regression and case-control matching, there were no significant differences in executive function or processing speed between intersex individuals and non-intersex individuals. Conclusion: Mental health differences between intersex and non-intersex individuals may account for differences in cognitive factor scores.

Boosting Career Success: Innovative Behavioral Measures for Guiding Saudi Secondary School Graduates

This study developed and validated a comprehensive behavioral measure for career guidance among secondary school graduates in Saudi Arabia, aiming to integrate soft skills, personality traits, attitudes, and cognitive factors to fill gaps in existing career guidance frameworks. Using a cross-sectional design, data were collected from 814 secondary school students (M_age = 16.47) from diverse urban (n = 407) and rural (n = 407) settings in Saudi Arabia. Multigroup latent profile analyses (LPA) were employed to identify distinct career decision-making profiles among students. The study explored whether urban and rural students exhibited different patterns of engagement in career guidance behaviors. Three distinct engagement profiles were identified: high, moderate, and low engagement, consistent across both settings. High engagement profiles were characterized by high self-efficacy, proactive career exploration, and low anxiety, linked to better career decision outcomes and greater satisfaction with career guidance. Variance analysis using the Games-Howell post hoc test was conducted to compare the profiles based on key behavioral measures such as self-efficacy, career exploration behavior, and anxiety. To further understand the contextual factors influencing these profiles, a multinomial regression analysis examined the impact of teacher support and resilience on career guidance engagement levels. Results indicated that higher levels of teacher support and resilience significantly predicted membership in high engagement profiles. These findings highlight the importance of incorporating behavioral components into career guidance programs, particularly those tailored to address the specific needs of urban and rural students in Saudi Arabia, ultimately supporting the broader educational and workforce development goals of Vision 2030.

Correlates of Lifestyle Physical Activity Among Young Arab American Women.

Young Arab American women are at risk for cardiovascular disease, but there is limited data on their physical activity (PA) engagement. The aim of this study was to examine the relationship between PA and its correlates in young Arab American women. The objectives of this study were to: (1) describe self-reported lifestyle PA behaviors of young Arab American women and (2) examine the relationship between their self-reported lifestyle PA, device-measured lifestyle PA (combined moderate/vigorous and steps), and potentially associated factors (demographics, physical measures, individual factors, and behavior cognition factors). This cross-sectional study was conducted with women 18 to 35 years of age and Arab American (n = 50) in the Midwest Region of the United States. Participants wore ActiGraph GT3X-BT monitors for 7 days; self-report measures included the International Physical Activity Questionnaire, demographics, acculturation, discrimination, religiosity, self-efficacy, and social support. The mean age of participants was 25.5 years (SD: 5.5; range: 18-35). Per ActiGraph, the average daily steps were 5946 (SD: 2783); only 24% met the moderate-intensity PA guidelines. Self-efficacy was significantly associated with increased moderate-to-vigorous PA (B = 0.37; P = .012). The average daily steps for the young Arab American women in this study were of low active classification. More than 75% of the women failed to meet the recommended weekly moderate/vigorous PA guidelines. Our study supports the importance of targeting and tailoring PA interventions on young Arab American women who have low self-efficacy for overcoming barriers to lifestyle PA.

Consumption Habits in Revenge-Buying: A Conceptual Model Integrating Protection Motivation Theory and the Concept of Attitudes

Upon lifting lockdown measures, pent-up consumer demand resulted in a phenomenon known as “revenge-buying” that was influenced by cognitive and habitual factors. This study collected 629 samples from Beijing consumers using straightforward online random sampling methods, ensuring the sample’s representativeness. Structural equation modeling was employed to investigate the impact of cognitive factors on revenge-buying after lockdowns and explain this phenomenon from the consumers’ habitual behavior perspective. Specifically, we developed a novel model that incorporates insights from the concept of attitudes and habits literature within the framework of the protection motivation theory to address this research question. The results reveal that habit significantly affects all cognitive factors, except response cost. Cognitive factors such as perceived severity, perceived vulnerability, response efficacy, self-efficacy, and response cost all play a role in shaping consumers’ attitudes and driving revenge-buying behavior. Furthermore, consumers’ habits contribute significantly to their likelihood of revenge-buying. This study provides empirical evidence for revenge-buying, and the proposed theoretical model offers a more complete understanding of the cognitive factors and habits that drive this behavior. These findings can help businesses to attract consumers, improve satisfaction, and better compete in the context of revenge-buying, ultimately benefiting both consumers and businesses involved in this behavior.

Forecasting the evolution of urban mobility: The influence of anthropomorphism and social responsiveness in the transition from human to automated driving

The transition to automated driving has prompted efforts to anthropomorphize urban transportation, aiming to replicate traditional driver-pedestrian interactions and enhance safety when human drivers are absent. However, prior research on anthropomorphism has shown inconsistency, potentially hindering its practical implementation in pedestrian-vehicle interactions. This study addressed these inconsistencies by examining the contingent role of social responsiveness. Using a 2 × 2 between-subjects experimental design, this study investigated the crossover interaction effects of anthropomorphism and social responsiveness on pedestrian-vehicle interactions at urban crossings. Two sequential studies were conducted: Study 1 examined the crossover interaction effects on cognitive factors and behavioral consequences (responsibility attribution and behavioral intention). Study 2 delved into the underlying mechanisms and contingencies of these interactions. Results reveal: (1) combining anthropomorphism and social responsiveness is crucial for effective pedestrian crossing and communication in the absence of human drivers; (2) the positive effects of this combination on responsibility attribution and behavioral intention are mediated by cognitive factors; and (3) non-responsive humanoid vehicles may not measure up to non-responsive, non-humanoid vehicles, yet responsive humanoid vehicles can outperform responsive, non-humanoid vehicles. These findings support the theory and guide the development of secure, interactive designs for the next generation of urban mobility in the transition to automated driving.

Approaches to Improve the Sleep Quality in Long Covid Patients: A Systematic Review

Background: Given the high prevalence of Long COVID, sleep problems have emerged as a significant issue for individuals after COVID-19 infection, potentially impacting their quality of life. Objective: Our study aims to identify effective strategies for improving sleep quality and offers recommendations for future research. Methods: The present systematic review study investigated ways to improve sleep quality in Long COVID patients. The study was conducted according to the updated PRISMA guidelines. The risk of bias was assessed using ROB 2.0. Results: Finally, six articles were included in the present study to identify strategies for improving and enhancing sleep quality in Long COVID. The results of the present study indicate that various interventions have been carried out to improve sleep quality, including psychological, cognitive, and physical factors related to long-term COVID-19 conditions. Conclusion: Based on existing evidence, interventions such as mind meditation, yoga, and hyperbaric oxygen therapy have demonstrated efficacy in enhancing sleep quality among Long COVID patients.

The utility of high-dosage experiments in everyday life to test theories in clinical science.

This viewpoint article discusses the utility of high-dosage experiments (HDEs) in everyday life to test theories in clinical science. HDEs involve experimental manipulations and assessments that occur over much longer periods of time than traditional experiments-generally days or even weeks. By nature, they also occur outside the lab, in the everyday environments of participants. Additionally, as with other experiments, the purpose of the study is concealed from participants. Experimental design is one of the most distinguishable characteristics of psychology that separates it from other behavioral sciences. Studies that rely on experiments are essential for theory testing and establishing the potential causal role of mechanisms that underlie psychopathology. Yet despite the value of experimental research, experimental studies are not currently given special prominence in clinical psychological science. For example, in the Journal of Psychopathology and Clinical Science, of all the empirical studies in the most recent year (2023), only three of 77 incorporated an experimental manipulation. Experimental research appears to be less popular in clinical psychology than in other fields, such as social psychology. What might account for this discrepancy? First, clinical samples are more difficult to recruit. This is important because experimental manipulations may produce small effects that require large samples for detection. Additionally, mechanisms hypothesized to underlie psychopathology are often chronic and intransigent. For example, cognitive factors (e.g., perfectionistic beliefs) could require an especially strong manipulation to modify in isolation. Researchers have argued that psychology has been experiencing a crisis in theory development. Eronen and Bringmann (2021) stated that one major reason for this crisis is the difficulty in establishing causal relationships between psychological constructs. The replication crisis has garnered even more attention (Open Science Collaboration, 2015). HDEs would help address these two crises and provide stronger and more replicable tests of theory. This could allow us to more precisely identify important mechanisms underlying psychopathology, potentially enhancing treatment efficacy, and enabling us to move the field forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Menopause and Sexual Life Amongst Older Men: A Review Study

Objectives: To determine factors affecting the quality of men’s sexual life during menopause and identify the existing challenges. Design: A review study. Setting(s): Older people living in public institutions and living in their own homes. Participants: Older adults over 60 years of age. Outcome measures: All factors affecting the quality of sexual life of postmenopausal men in old age have been investigated in three physical, psycho-emotional, and social domains. Results: In the physical field, factors such as age, general health, disease, exercise, impotence, erectile dysfunction, genital warts, surgery of total hip arthroplasty, surgery of prostate, cancer radiotherapy, alopecia, and disorder in ejaculation, urinary disorders, and physical rehabilitation were known factors affecting the quality of men’s sexual life. The impacts of factors such as sleep problems, stressors, self-image, depression, alcohol addiction, premature ejaculation, emotional divorce, marital satisfaction, and fear of sexual activity were confirmed in the psycho-emotional field of studies. In the social field, factors such as education, duration of the marriage, marital status, income, life partners, number of sexual relations with spouse, the presence of multiple sexual partners, body mass of spouse (female), sex education and health literacy, sexual awareness, and quality of life related to health were recognized to be effective. Conclusions: Promoting sexual awareness through educational programs, providing opportunities for frequent sexual relationships, and addressing physical, psychological, emotional, cognitive, and social factors, and andropause could contribute to a more desirable sexual life quality in men during andropause.

Enhancing mandarin learning through classroom response apps: A comparison of cognitive and affective factors in touch and shaking responses

Enhancing mandarin learning through classroom response apps: A comparison of cognitive and affective factors in touch and shaking responses

Association between gray matter regional structural-functional connectivity couplings and visual memory in major depressive disorder.

Alterations in structural-functional (SC-FC) coupling have been linked to major depressive disorder (MDD). A newly developed algorithm for regional-specific SC-FC coupling analysis shows potential in advancing psychiatric research. In this study, we calculated the gray matter regional-specific SC-FC coupling of 114 MDD patients and 131 healthy controls (HCs). The delayed matching to sample (DMS) and Pattern Recognition Memory (PRM) subtests of the computerized Cambridge Neurocognitive Test Automated Battery (CANTAB) were used to evaluate visual memory. We found that the Xgboost model exhibited robust discriminative performance (Area under the ROC curve [95% CI]: 0.75 [0.65 to 0.85], Accuracy [95% CI]: 0.73 [0.63 to 0.84], Sensitivity [95% CI]: 0.65 [0.53 to 0.76], Specificity [95% CI]: 0.82 [0.77 to 0.87]). MDD patients showed lower SC-FC coupling in the left inferior frontal orbital gyrus (IFGorb_L) and the right inferior occipital gyrus (IOG_R) and higher SC-FC coupling in the left superior temporal pole (TPOsup_L) and the right middle temporal pole (TPOmid_R) than HCs. SC-FC coupling of IFGorb_L negatively correlated with current duration of illness (r = -0.26, P = 0.007), IOG_R negatively correlated with HAMD-17 cognitive factor score (r = -0.24, P = 0.011), while TPOsup_L positively correlated with percent correct in PRM delayed task among MDD patients (r = 0.31, P = 0.003). In conclusion, the study suggested that altered regional SC-FC coupling may be involved in MDD pathophysiology and associated with visual memory impairment.

Color-induced cognitive conflicts affect muscle activity prior to gait initiation in the Go/No-go task.

In traffic rule, green/blue means go, and red means stop. It has been shown that this prior knowledge about traffic signal colors can affect reaction times (RTs). For example, RTs are longer when responding to a red "Go" signal and withholding the response to a blue "No-go" signal (Red Go/Blue No-go task) than when responding to a blue "Go" signal and withholding the response to a red "No-go" signal (Blue Go/Red No-go task), when responses are provided by button press. However, it remains unknown whether this holds in different actions. The aim of this study was to investigate the effect of prior knowledge of color on gait initiation in a Go/No-go task. Seventeen participants performed Green Go/Red No-go and Red Go/Green No-go tasks, in which they stepped forward from a force plate in response to a green or red signal and withhold the response to red or green signal, respectively. We recorded the center of pressure (COP) and electromyogram (EMG) from the bilateral tibialis anterior muscles during gait initiation. The onset of COP movement and toe-off time as well as COP displacements did not differ between the Go/No-go tasks. The EMG onset for the stance leg was delayed in the Red Go/Green No-go than Green Go/Red No-go task. These findings suggest that the conflict between prior knowledge of color related to traffic rule and the meaning of the stimulus color affects muscle activity but not COP characteristics during gait initiation, highlighting two distinct motor control mechanisms, where the initial phase is influenced by cognitive load while the subsequent phase remains unaffected. This dissociation suggests that the later phase of gait initiation relies on robust spinal loops and central pattern generators, which are less influenced by cognitive factors such as prior knowledge.

To Be in Pain: Pain Multidimensional Questionnaire as Reliable Tool to Evaluate Multifaceted Aspects of Pain

Background/Objectives: Pain is a multidimensional experience influenced by sensory, emotional, and cognitive factors. Traditional pain assessments often fail to capture this complexity. This study aimed to develop and validate the Pain Multidimensional Questionnaire (Pa-M-QU), a new self-report tool designed to assess pain catastrophizing, sensitivity, and coping strategies. Methods: Two independent samples of Italian-speaking participants, aged 18 and above, were recruited online. The first sample (n = 392; mean age = 29.36) was used for exploratory factor analysis (EFA), and the second sample (n = 123; mean age = 28.0) for confirmatory factor analysis (CFA). Pearson’s correlations and convergent validity analyses were conducted. Results: From an initial pool of 59 items identified through focus group discussions, 35 items were removed based on reliability analysis. The final 24-item Pa-M-QU features a three-factor structure: catastrophizing, pain sensitivity, and coping with pain. Conclusions: The Pa-M-QU offers a rapid, non-invasive assessment that captures the multidimensional nature of pain. It is a starting point to develop tools for both clinical and research settings, aiding in evaluating pain in healthy individuals and predicting acute and chronic pain disorders. Future research should focus on refining the Pa-M-QU for broader clinical applications and exploring its potential to complement or replace traditional pain assessments, thereby advancing pain management and research.

Do social cognitive factors influence final-year undergraduate students’ intentions to pursue advanced degrees? An examination of the moderating effect of sex

This study explores the factors influencing final-year undergraduate students’ intentions to pursue advanced degrees through the lens of social cognitive theory (SCT). In addition, it investigates the moderating effect of sex on the causal pathways in the proposed model. Using a quantitative cross-sectional survey design, 578 final-year undergraduate students from various degree programs participated in an online survey. The results revealed that outcome expectations and social support are significant predictors of intention, while intention itself predicts the implementation of intentions to pursue an advanced degree. However, self-efficacy was not found to influence intention, and sex did not moderate the hypothesized paths in the model. These findings suggest that SCT provides a useful and robust framework for understanding the factors shaping undergraduate students’ intentions to pursue advanced degrees, as evidenced by the high explanatory power of the structural model. The study also offers practical and theoretical implications, along with suggestions for future research.

Cognitive, affective, and normative factors affecting digital insurance adoption among persons with disabilities: A two-stage SEM-ANN analysis

This study evaluates the determinants of digital insurance adoption among persons with disabilities (PWDs) using the cognitive, affective, and normative (CAN) model. The study considers (i) cognitive factors such as perceived credibility, perceived knowledge, perceived usefulness, perceived complexity, and facilitating conditions; (ii) affective factors including technology anxiety and technology pleasure; and (iii) normative factors encompassing social influence. Moreover, it explores the relationship between perceived complexity and behavioral intention (BI) to adopt digital insurance among PWDs, as mediated by perceived knowledge. This study employs a two-stage hybrid structural equation modeling–artificial neural network (SEM-ANN) approach to test the hypothesis, and data from 323 physically challenged participants were collected. Empirical results show that all factors, except for perceived complexity and technological anxiety, significantly predict BI adoption of digital insurance among PWDs, whereas perceived usefulness was found to have the highest impact on BI. Although perceived complexity affects perceived knowledge, it does not significantly mediate the relationship between complexity and BI. This study expands on the CAN model and provides practical insights for PWDs in adopting digital insurance.

No Impact of Anthropometric and Fitness Factors on Speed-Agility in Young Soccer Players: Is It a Cognitive Influence?

Agility in young soccer players has long been associated with physical attributes like strength, speed, and power. The aims of this study were toinvestigate the relationship between cognitive factors and agility performance in this unique population. 39 young soccer players age 13.56 (SD 0.58)years were assessed for leg-muscle function (jump tests) and maturation status (peak height velocity). TheY-Agility Test, which included decision making in players, was used to measure performance. Cognitive factors such as perceptual skillsand decision making were evaluated with theY-Agility Test. The linear regression showed an absence of significance between theY-Agility Test and drop-jump contact (P = .283), Y-Agility Testand drop-jump flight (P = .185), Y-Agility Test and squat jump (P = .868), and Y-Agility Test and countermovement jump (P = .310). The linear mixed-model analyses suggested a difference between early-average maturers (P = .009) and early-late maturers (P = .005) but did not show a difference between average-late subjects (P = 1.000). Drop-jump flight did not show a difference in maturation (early-average P = 1.000; early-late P = 1.000; average P = 1.000). Squat-jump performance did not demonstrate any significance (early-average P = .618; early-late P = 1.000; P = 1.000). Countermovement-jump performance did not show any significance (early-average P = 1.000; early-late P = 1.000; average-late P = .492). Finally, agility performance does not show any significance between maturation levels(early-average maturer P = .450; early-late P = 1.000; average-late P = .830). Agility in young soccer players appears to follow a nonlinear trajectory, with cognitive factors possibly playing a more significant role than previously thought.

Factors Guiding Clinical Decision-Making in Genitourinary Oncology.

Clinical decision-making in oncology is a complex process, with the primary goal of identifying the most effective treatment tailored to individual cancer patients. Many factors influence the treatment decision: disease- and patient-specific criteria, the increasingly complex treatment landscape, market authorization and drug availability, financial aspects, and personal treatment expertise. In the domain of genitourinary cancers, particularly prostate cancer, decision-making is challenging. Despite the prevalence of this malignancy, there are few in-depth explorations of these factors within real-world scenarios. Understanding and refining this intricate decision-making process is essential for future successful clinical decisions and the integration of computerized decision support into clinicians' workflows. The objective of this study is to improve the current knowledge base and evidence of the factors that influence treatment decision-making for patients with genitourinary cancers. Assessment of how routine treatment decisions are made for genitourinary cancers was performed by a mixed-methods study, encompassing field observations and focus group discussions. In total, we identified 59 factors that influence clinical decision-making in oncology, specifically for genitourinary and prostate cancer. Of these, 23 criteria can be classified as decision-maker-related criteria encompassing personal, cognitive, and emotional attributes and factors of both, healthcare professionals and patients. Moreover, 20 decision-specific criteria have been identified that refer to clinical and disease-related factors, followed by 16 contextual decision factors that describe the relevant criteria introduced by the specific circumstances and environment in which the treatment decision is made. By presenting an exhaustive set of decision factors and providing specific examples for genitourinary cancers, this observational study establishes a possible framework for a better understanding of decision-making. Moreover, we specify and expand the set of decision factors, while emphasizing the importance of cognitive, emotional, and human factors, as well as the quality and accessibility of decision-relevant information.

Disentangling negative reinforcement, working memory, and deductive reasoning deficits in elevated BMI

Neuropsychological data suggest that being overweight or obese is associated with a tendency to perseverate behavior despite negative feedback. This deficit might be observed due to other cognitive factors, such as working memory (WM) deficits or decreased ability to deduce model-based strategies when learning by trial-and-error. In the present study, a group of subjects with overweight or obesity (Ow/Ob, n = 30) was compared to normal-weight individuals (n = 42) in a modified Reinforcement Learning (RL) task. The task was designed to control WM effects on learning by manipulating cognitive load and to foster model-based learning via deductive reasoning. Computational modelling and analysis were conducted to isolate parameters related to RL mechanisms, WM use, and model-based learning (deduction parameter). Results showed that subjects with Ow/Ob had a higher number of perseverative errors and used a weaker deduction mechanism in their performance than control individuals, indicating impairments in negative reinforcement and model-based learning, whereas WM impairments were not responsible for deficits in RL. The present data suggests that obesity is associated with impairments in negative reinforcement and model-based learning.

Health literacy after traumatic brain injury: characterisation and control comparison.

Background Little is known about health literacy in traumatic brain injury (TBI) survivors. The aims of this study were to compare health literacy in individuals with TBI with that of a control group; to examine the association between health literacy in individuals with TBI and demographic, injury, and cognitive factors; and compare the relationship between health literacy and physical and mental health outcomes. Methods A cross-sectional observational study design was used. Adults (≥18years) were recruited from an outpatient research centre in Victoria, Australia. There were 209 participants with a complicated mild to severe TBI at least 1year previously (up to 30years 6months) and 206 control participants. Results Individuals with TBI did not have poorer health literacy than controls (IRR=1.31, P =0.102, CI95% [0.947, 1.812]). Further analysis could not be completed due to the highly skewed Health Literacy Assessment Using Talking Touchscreen Technology - Short Form (Health LiTT-SF) data. Conclusion Health literacy performance in individuals with TBI was not significantly different to controls. Premorbid education may provide a critical cognitive reserve upon which TBI survivors can draw to aid their health literacy. These findings are specific to the Health LiTT-SF measure only and require replication using more comprehensive health literacy measures in culturally diverse samples.

Structural inequality and temporal brain dynamics across diverse samples.

Structural income inequality - the uneven income distribution across regions or countries - could affect brain structure and function, beyond individual differences. However, the impact of structural income inequality on the brain dynamics and the roles of demographics and cognition in these associations remains unexplored. Here, we assessed the impact of structural income inequality, as measured by the Gini coefficient on multiple EEG metrics, while considering the subject-level effects of demographic (age, sex, education) and cognitive factors. Resting-state EEG signals were collected from a diverse sample (countries=10; healthy individuals=1394 from Argentina, Brazil, Colombia, Chile, Cuba, Greece, Ireland, Italy, Turkey and United Kingdom). Complexity (fractal dimension, permutation entropy, Wiener entropy, spectral structure variability), power spectral and aperiodic components (1/f slope, knee, offset), as well as graph-theoretic measures were analysed. Despite variability in samples, data collection methods, and EEG acquisition parameters, structural inequality systematically predicted electrophysiological brain dynamics, proving to be a more crucial determinant of brain dynamics than individual-level factors. Complexity and aperiodic activity metrics captured better the effects of structural inequality on brain function. Following inequality, age and cognition emerged as the most influential predictors. The overall results provided convergent multimodal metrics of biologic embedding of structural income inequality characterised by less complex signals, increased random asynchronous neural activity, and reduced alpha and beta power, particularly over temporoposterior regions. These findings might challenge conventional neuroscience approaches that tend to overemphasise the influence of individual-level factors, while neglecting structural factors. Results pave the way for neuroscience-informed public policies aimed at tackling structural inequalities in diverse populations.

Exercise, memory, and the hippocampus: Uncovering modifiable lifestyle reserve factors in refractory epilepsy

Physical exercise is an emerging target for improving cognition in aging and neurological disease. Due to the beneficial impact of exercise on hippocampal health and the vulnerability of the hippocampus in medication-resistant temporal lobe epilepsy (TLE), exercise could present a promising intervention in TLE. We investigated whether exercise engagement is associated with verbal memory function and hippocampal integrity in 29 young to middle-aged adults with refractory TLE and 21 demographically matched controls. Participants completed a self-reported questionnaire of weekly exercise, three tests of verbal memory, and a subset (n = 44) underwent structural MRI. Individuals with TLE self-reported lower exercise scores than controls across all levels of exercise intensity (p < 0.001). In TLE, greater exercise engagement was associated with better verbal memory (word-list recall and associative learning; rho = 0.46–0.47; ps FDR < 0.05), and with larger contralateral hippocampal volumes (rho = 0.61; p < 0.01). These effects remained significant when controlling for several clinical and demographic factors. These findings suggest that exercise may be a cognitive reserve factor in TLE, potentially mitigating memory decline by enhancing contralateral hippocampal integrity. With future replication and longitudinal investigation, exercise holds promise as a low-cost and accessible modifiable lifestyle target for improving cognitive health in individuals with refractory TLE