Functional connectivity changes and symptoms improvement after personalized, double-daily dosing, repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: A pilot study

•Double-daily fMRI-guided rTMS applied to the SMA is safe and feasible.•Individualized rTMS significantly improves both obsessions and compulsions.•The clinical effect of rTMS persists in the long-term follow-up.•RTMS to the SMA induces a significant reduction in the rsFC within the CSTC circuit.•Clinical improvements by rTMS correlate with changes in rsFC.