Dear Editor;

We have closely read the paper by Cardoso Vale et al,1 aimed at comparing the clinical and radiological features between patients with Parkinson's disease (PD) and those with vascular parkinsonism (VP). The article seeks to provide key clinical data that may help in the definition and distinction of these illnesses. To accomplish this, the authors performed a large body of assessments on a small sample of patients. We would like to make some comments on the rationale of the evaluations that were carried out; because, in our view, the authors’ approach on the assessment of the groups of patients was sometimes made under inaccurate concepts and there is a need for clarification.

It is well known that pure VP without evidence for nigral Lewy body pathology may occur as a distinct clinicopathological entity, but the presence of age-associated white …