IRCT2014112919808N2 IRCT 2014-12-08 Hamadan University of Medical Science Study of Effects of Repetitive Transcranial Magnetic Stimulation on Executive Function of Refractory Obsessive Compulsive Disorder Patients Study of Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) on Executive Function in Patients of Refractory Obsessive Compulsive Disorder 2014-12-11 anticipated 10 Complete https://irct.ir/trial/17619 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Used, Assignment: Crossover, Purpose: Treatment. N/A refractory obsessive compulsive disorder. Intervention 1: Intervention (refractory transcranial magnetic stimulation (rTMS)): Bilateral rTMS will be delivered according to the following protocol: high frequency left (HFL) stimulation will initially be applied at 20 Hz, in 25 trains of 1.5 second duration with a 30 second interval between trains and at 100% of the RMT for a total of 25 minutes of stimulation. Following this HFR stimulation will be applied at the same parameters. Therefore a total of 50 minutes of stimulation will be delivered. Intervention 2: Control (Sham condition): Sham stimulation will be made at the site of active treatment but with only the side edge resting on the scalp. It will be administered as HFL and HFR for 50 minutes but with the coil angled 45-90 degrees away from the skull in a single-wing tilt position. This method produces sound and some somatic sensation (e.g., contraction of scalp muscles) similar to those with active stimulation but with minimal direct brain effects. Participants will be unable to see the stimulating coil and therefore will remain blind to the treatment condition.