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An association between the presence of TDP-43 in the spinal cord and CTE cases with a progressive motor neuron disease, amyotrophic lateral sclerosis (ALS), is evidence that repetitive head trauma might be linked to impairments in the motor system

However, rare but severe adverse effects can occur upon long-term exposure or high doses, like osteonecrosis of the jaw or atypical femoral fractures (45)