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IRCT20211121053132N4 IRCT 2026-04-15 Esfahan University of Medical Sciences Comparison of Two Types of Brain Magnetic Stimulation for Improving Symptoms in Patients with Obsessive-Compulsive Disorder A Comparative Study of the Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) at 1 Hz and 0.5 Hz in Improving Symptoms of Patients with Obsessive-Compulsive Disorder 2026-04-21 anticipated 80 Complete https://irct.ir/trial/89385 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: Participants will allocate to the two treatment groups using block randomization with a block size of 2. The possible allocation sequences will be AB and BA. For each block, one sequence will select using a random number table, and participants will assign accordingly in the order of enrollment to ensure balance between groups, Blinding description: In this study, the outcome assessor (Y-BOCS evaluator) will blind to group allocation. Due to the nature of the intervention,. 2 Obsessive-compulsive disorder. Intervention 1: Intervention group: Participants in this group receive repetitive transcranial magnetic stimulation at a frequency of 1 hertz. The intervention consists of 10 treatment sessions every other day over 3 weeks. In each session, stimulation is delivered at 100 percent of motor threshold, with 15 trains and 100 pulses per train, using the Super Rapid 2 device, with the coil positioned over the dorsolateral prefrontal cortex. Intervention 2: Intervention group: Intervention group: Participants in this group receive repetitive transcranial magnetic stimulation at a frequency of 0.5 hertz. The intervention consists of 10 treatment sessions every other day over 3 weeks. In each session, stimulation is delivered at 100 percent of motor threshold, with 15 trains and 100 pulses per train, using the Super Rapid 2 device, with the coil positioned over the dorsolateral prefrontal cortex. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is A final decision has not yet been made regarding sharing deidentified individual participant data. The final decision will be made after study completion in accordance with ethical considerations, data confidentiality, and institutional policies.

public Gholamreza Asgari

Building No. 4, Vice Chancellor for Research and Technology, Hezar Jarib Avenue , Isfahan University of Medical Sciences and Health Services,

Isfahan Iran (Islamic Republic of) 8174673461 +98 31 3668 7898 research@mui.ac.ir Esfahan University of Medical Sciences scientific Gholamreza Asgari

Building No. 4, Vice Chancellor for Research and Technology, Hezar Jarib Avenue , Isfahan University of Medical Sciences and Health Services,

Isfahan Iran (Islamic Republic of) 8174673461 +98 31 3668 7898 research@mui.ac.ir Esfahan University of Medical Sciences Iran (Islamic Republic of) Patients with a diagnosis of obsessive-compulsive disorder confirmed by a psychiatrist based on DSM-5 criteria inadequate response to at least two selective serotonin reuptake inhibitors (SSRIs) and clomipramine (each administered for at least 6 weeks), non-response to cognitive behavioral therapy (CBT). 18 years 65 years Both uncontrolled psychiatric comorbidities such as major depression or anxiety disorders, significant active medical conditions, history of epilepsy or other neurological disorders, contraindications to transcranial magnetic stimulation (including metallic implants in the head or neck), unwillingness to participate in the study. F42 Obsessive-compulsive disorder Treatment - Devices Treatment - Devices Intervention group: Participants in this group receive repetitive transcranial magnetic stimulation at a frequency of 1 hertz. The intervention consists of 10 treatment sessions every other day over 3 weeks. In each session, stimulation is delivered at 100 percent of motor threshold, with 15 trains and 100 pulses per train, using the Super Rapid 2 device, with the coil positioned over the dorsolateral prefrontal cortex. Intervention group: Intervention group: Participants in this group receive repetitive transcranial magnetic stimulation at a frequency of 0.5 hertz. The intervention consists of 10 treatment sessions every other day over 3 weeks. In each session, stimulation is delivered at 100 percent of motor threshold, with 15 trains and 100 pulses per train, using the Super Rapid 2 device, with the coil positioned over the dorsolateral prefrontal cortex. Change in total score of the Yale Brown Obsessive Compulsive Scale. Timepoint: At baseline before the intervention and at the end of the study after completion of the tenth treatment session. Method of measurement: Yale Brown Obsessive Compulsive Scale administered through interview and scored by the evaluator. Total score of the Yale Brown Obsessive Compulsive Scale at baseline. Timepoint: At baseline before the intervention. Method of measurement: Yale Brown Obsessive Compulsive Scale administered through interview and scored by the evaluator. Total score of the Yale Brown Obsessive Compulsive Scale at the end of the study. Timepoint: At the end of the study after completion of the tenth treatment session. Method of measurement: Yale Brown Obsessive Compulsive Scale administered through interview and scored by the evaluator. Esfahan University of Medical Sciences Approved 2025-12-01 Ethics committee of Isfahan University of Medical Sciences Hezar Jerib Avenue Isfahan Isfehan Iran (Islamic Republic of)