Current therapies for Parkinson’s disease (PD) are solely symptomatic, with no disease-modifying strategies available so far. Clinical trials to date have considered PD to be a single entity with abnormal protein aggregation at the root of the disease. Alberto Espay, MD, FAAN, University of Cincinnati, Cincinnati, OH, shares his thoughts on current investigational approaches and concerns that a different path may be more appropriate. Given the pathological heterogeneity of PD, Prof. Espay feels that disease-modifying efforts should refocus on addressing individual biological subtypes. This interview took place during the American Academy of Neurology (AAN) 2021 Annual Meeting.