Alberto Espay, MD, FAAN, University of Cincinnati, Cincinnati, OH, talks on the Braak hypothesis of Lewy pathology progression in Parkinson’s disease (PD) and the need to reject it. The classical Braak hypothesis suggests that PD begins as a synucleinopathy in the lower brainstem or in the olfactory bulb which goes on to spread throughout the brain in a stereotyped pattern. Prof. Espay discusses the issues with the hypothesis noting that, based on the data gathered to date, there is no relationship between Braak stage and clinical severity of PD or the level of degeneration. There is also no support for a spread of Lewy pathology that precedes neurodegeneration and the onset of clinical symptoms. This interview took place during the 2021 International Congress of Parkinson’s Disease and Movement Disorders.