Effectiveness of Low-Frequency rTMS and CBT in Reducing Symptoms Severity and Improving Cognitive Flexibility in Adults with OCD: A Clinical Tria

Background: This study aims to assess and compare the effects of low-frequency (LF) cognitivebehavioral therapy (CBT) and repetitive transcranial magnetic stimulation (rTMS) on symptoms and cognitive flexibility of adults with OCD.Methods: This is a randomized clinical trial conducted on 24 people with OCD in Zanjan, Iran in two groups of CBT (n=12) and rTMS (n=12).The CBT with exposure and response prevention was presented at 20 sessions.The 1-Hz rTMS was delivered at 100 of resting MT using an 8shaped coil over the right dorsolateral prefrontal cortex (F4) for 2 weeks at 10 sessions.They completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Cognitive Flexibility Inventory before, immediately, and one month after the intervention.Collected data were analyzed in SPSS v.22 software.Results: Results showed a significant difference between the two groups in the severity of OCD symptoms (obsessions and compulsions) immediately after intervention (p<0.001),where higher reductions were observed in the CBT group.There was no significant difference between the two groups in cognitive flexibility (p>0.05).No significant difference was found between the groups in any study variables one month after interventions. Conclusion:There is a significant difference between CBT and LF rTMS techniques in reducing the severity of OCD symptoms, while there is no difference between them in improving cognitive flexibility of patients with OCD.