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Comparative Study of the Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Two Anatomical Regions of the Right DLPFC and the SMA on the Symptoms of Patients With Obsessive-Compulsive Disorder

Protocol summary

Study aim
The aim of this study is to compare the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on the Right Dorsolateral Prefrontal Cortex (DLPFC) and the Supplementary Motor Area (SMA) on reducing symptoms in patients with Obsessive-compulsive Disorder (OCD), and to help develop a more precise and effective adjunctive treatment protocol for OCD.
Design
This is an open-label, randomized clinical trial without a control group. Participants are allocated to two intervention groups (DLPFC and SMA) using randomized blocks, with assignment determined by the last digit of the national ID and a random number.
Settings and conduct
This study takes place at the psychiatry clinic of the Isfahan University of Medical Sciences, Khorshid Hospital. Eligible OCD patients, after informed consent, undergo rTMS targeting either DLPFC or SMA.
Participants/Inclusion and exclusion criteria
Inclusion Criteria: Adults between 18 and 65 years old, diagnosed with OCD based on the Diagnostic And Statistical Manual (DSM 5) who are capable of providing informed consent. Exclusion Criteria: Participants who have a history of seizure, or metal implants in or near the head, or significant neurological or psychiatric disorders, or history of substance abuse within the past 6 months, or individuals who are currently pregnant or lactating.
Intervention groups
Intervention Group 1 (DLPFC Group): Participants in this group receive rTMS on the right DLPFC. Intervention Group 2 (SMA Group): Participants in this group receive rTMS on the SMA.
Main outcome variables
Decreasing symptoms of OCD

General information

Reason for update
Acronym
DLPFC-SMA-OCD
IRCT registration information
IRCT registration number: IRCT20260519069451N1
Registration date: 2026-07-22, 1405/04/31
Registration timing: registered_while_recruiting

Last update: 2026-07-22, 1405/04/31
Update count: 0
Registration date
2026-07-22, 1405/04/31
Registrant information
Name
Faranak Zakizadeh
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 31 3662 7821
Email address
faranak@med.mui.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2026-06-22, 1405/04/01
Expected recruitment end date
2026-09-23, 1405/07/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Comparative Study of the Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Two Anatomical Regions of the Right DLPFC and the SMA on the Symptoms of Patients With Obsessive-Compulsive Disorder
Public title
Effect of Magnetic Brain Stimulation in Two Different Regions on OCD Symptoms
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Adults aged between 18 and 65 years old Individuals with a confirmed diagnosis of OCD based on DSM-5 criteria Individuals who are capable of providing informed consent
Exclusion criteria:
Participants who have a history of seizure or epilepsy Participants who have metal implants in or near the head Participants who have significant neurological or psychiatric disorders (e.g., schizophrenia, bipolar disorder) Participants who have a history of substance abuse within the past 6 months Participants who are currently pregnant or lactating
Age
From 18 years old to 65 years old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size: 64
Randomization (investigator's opinion)
Randomized
Randomization description
In the sampling method, 32 randomized blocks of two are used. In this way, every two individuals who enter the study according to the inclusion and exclusion criteria form a block of two. The participant with the lower national ID number is assigned the number 1, and the other participant is assigned the number 2. Then, we receive a random number from a calculator; if the number 0, 1, 2, 3, or 4 is received, participant number 1 will be assigned to the DLPFC group, and participant number 2 will be assigned to the SMA group. If the numbers 5, 6, 7, 8, or 9 are received, participant number 1 will be assigned to the SMA group, and participant number 2 will be assigned to the DLPFC group.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Research Ethics Committees of School of Medicine - Isfahan University of Medical Sciences
Street address
Isfahan Medical School, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Isfahan, Iran
City
Isfahan
Province
Isfehan
Postal code
8174673461
Approval date
2025-11-22, 1404/09/01
Ethics committee reference number
IR.MUI.MED.REC.1404.336

Health conditions studied

1

Description of health condition studied
Obsessive-Compulsive Disorder (OCD) is a chronic psychiatric disorder characterized by the presence of obsessions (recurrent, intrusive, and unwanted thoughts, urges, or images) and/or compulsions (repetitive behaviors or mental acts performed to reduce anxiety or distress). OCD can significantly impair social, occupational, and academic functioning and reduce quality of life. Although pharmacotherapy and cognitive behavioral therapy are effective for many patients, a considerable proportion of individuals experience persistent symptoms, highlighting the need for alternative treatment approaches such as repetitive transcranial magnetic stimulation (rTMS).
ICD-10 code
F42
ICD-10 code description
Obsessive-compulsive disorder

Primary outcomes

1

Description
Decreasing of obsessive compulsive symptoms
Timepoint
Before the intervention, immediately after the final session of the intervention, and 4 weeks after the final session
Method of measurement
Yale Brown obsessive compulsive scale

Secondary outcomes

empty

Intervention groups

1

Description
Intervention group: the right DLPFC group; individuals receiving rTMS on the right DLPFC area. The intervention will be delivered in 15-minute sessions, five times a week for 10 sessions. All patients will receive routine pharmacological treatment for obsessive-compulsive disorder.
Category
Treatment - Other

2

Description
Intervention group: the SMA group; individuals receiving rTMS on the SMA area. The intervention will be delivered in 15-minute sessions, five times a week for 10 sessions. All patients will receive routine pharmacological treatment for obsessive-compulsive disorder.
Category
Treatment - Other

Recruitment centers

1

Recruitment center
Name of recruitment center
Khorshid Hospital
Full name of responsible person
Ali Shariat
Street address
Khorshid Hospital, Ostandari St., Isfahan, Isfahan, Iran
City
Isfahan
Province
Isfehan
Postal code
8174673461
Phone
+98 31 3668 0048
Email
nour@mui.ac.ir
Web page address
http://nour.mui.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Esfahan University of Medical Sciences
Full name of responsible person
Gholamreza Asgari
Street address
Isfahan University of Medical Sciences, Hezarjarib Ave., Isfahan, Isfahan, Iran
City
Isfahan
Province
Isfehan
Postal code
8174673461
Phone
+98 31 3668 0048
Email
international@mui.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Esfahan University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Esfahan University of Medical Sciences
Full name of responsible person
Faranak Zakizadeh
Position
Associate Professor
Latest degree
Specialist
Other areas of specialty/work
Psychiatrics
Street address
Isfahan Medical School, Isfahan University of Medical Sciences, Hezarjarib Ave., Isfahan
City
Isfahan
Province
Isfehan
Postal code
8174673461
Phone
+98 31 3792 8134
Email
faranak@med.mui.ac.ir

Person responsible for scientific inquiries

Contact
Name of organization / entity
Esfahan University of Medical Sciences
Full name of responsible person
Faranak Zakizadeh
Position
Associate Professor
Latest degree
Specialist
Other areas of specialty/work
Psychiatrics
Street address
Isfahan Medical School, Isfahan University of Medical Sciences, Hezarjarib Ave., Isfahan
City
Isfahan
Province
Isfehan
Postal code
8174673461
Phone
+98 31 3792 8134
Email
faranak@med.mui.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Esfahan University of Medical Sciences
Full name of responsible person
Faranak Zakizadeh
Position
Associate Professor
Latest degree
Specialist
Other areas of specialty/work
Psychiatrics
Street address
Isfahan Medical School, Isfahan University of Medical Sciences, Hezarjarib Ave., Isfahan
City
Isfahan
Province
Isfehan
Postal code
8174673461
Phone
+98 31 3792 8134
Email
faranak@med.mui.ac.ir

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
No - There is not a plan to make this available
Clinical Study Report
No - There is not a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
No - There is not a plan to make this available
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