en Clinical Neuroscience Clinical Neuroscience Original Original <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Tahoma;"><span style="line-height:2;"><strong>Introduction:</strong> This study aims to assess and compare the effects of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) and cognitive-behavioral therapy (CBT)on symptoms and cognitive flexibility of adults with obsessive-compulsive disorder (OCD).<br> <strong>Methods:</strong> This is a randomized clinical trial conducted on 24 people with OCD living in Zanjan City, Iran, in two groups of CBT (n=12) and rTMS (n=12). The CBT with exposure and response prevention (ERP) was presented at 20 sessions. The rTMS (1 Hz) was delivered at 100 resting motor thresholds using an 8-shaped coil over the right dorsolateral prefrontal cortex (DLPFC) (F4) for 2 weeks at 10 sessions. They completed the Yale-Brown obsessive-compulsive scale (Y-BOCS) and the cognitive flexibility inventory (CFI) before, immediately, and one month after the intervention. Collected data were analyzed in SPSS software, version 22.<br> <strong>Results:</strong> Results showed a significant difference between the two groups in the severity of OCD symptoms (obsessions and compulsions) immediately after the 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 variable one month after interventions.&nbsp;<br> <strong>Conclusion:</strong> 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 the cognitive flexibility of the patients.</span></span></span></div> Obsessive-compulsive disorder (OCD), Cognitive behavioral therapy (CBT), Repetitive transcranial magnetic stimulation (rTMS), Cognitive flexibility 519 532 http://bcn.iums.ac.ir/browse.php?a_code=A-10-5047-1&slc_lang=en&sid=1 Arash Fazeli fazeliarash@zums.ac.ir 13700319475328460053376 13700319475328460053376 No Department of Psychiatry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Ahmad Zolghadriha zolghadrihaahmad@gmail.com 13700319475328460053377 13700319475328460053377 No Department of Psychiatry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Reza Pirzeh pirzeh.rz@zums.ac.ir 13700319475328460053378 13700319475328460053378 No Department of Psychiatry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Shokoufe Ramezani Shokoo.ramezani@yahoo.com 13700319475328460053379 13700319475328460053379 No Department of Educational Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran. Mohsen Dadashi mohsendadashi.zums@gmail.com 13700319475328460053380 13700319475328460053380 Yes Department of Clinical Psychology, Social Determinants of Health Research Center, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.