President Joe Biden has not seen a neurologist outside his annual physicals, White House physician Kevin O’Connor said in a letter released Monday night addressing visits to the White House by a Parkinson’s disease expert.

The visits by the expert, Dr. Kevin Cannard, had raised questions that were left largely unanswered earlier Monday by White House press secretary Karine Jean-Pierre. Biden has been on the defensive trying to reassure Americans and Democratic lawmakers that he can run and win after a poor debate performance last month.

O’Connor wrote that Biden had a physical in February and that the president showed no signs of any neurological disorder, including Parkinson’s disease. In Monday’s letter, released by the White House, O’Connor referred to that physical.

“The results of this year’s exam were detailed in my February 28th letter: ‘An extremely detailed neurologic exam was again reassuring in that there were no findings which would be consistent with any cerebellar or other central neurological disorder, such as stroke, multiple sclerosis, Parkinson’s or ascending lateral sclerosis, nor are there any signs of cervical myelopathy,’” O’Connor wrote.

The White House Medical Unit has thousands of patients and normally does not share the names of physicians it works with, O’Connor wrote in the letter, addressed to Jean-Pierre.

“However, in the interests of accuracy, I have obtained permission from the President and Dr. Cannard to confirm the details I am sharing.”

NBC News earlier confirmed reporting from the New York Post that said a Parkinson’s expert from Walter Reed visited the White House at least eight times in an eight-month period, according to public visitor logs.

Jean-Pierre at a news briefing Monday said that Biden has a comprehensive physical evaluation that includes seeing a neurologist, and that the results have been publicly shared. She did not release names at that time, citing what she said were security concerns.

The letter also details Cannard’s background as a neurology specialist and notes that he has been the neurology consultant to the White House Medical Unit since 2012.

Before the Covid pandemic, the letter said, Cannard held regular neurology clinics at the White House medical clinic for the thousands of active-duty military members assigned to support White House operations.

“Seeing patients at the White House is something that Dr. Cannard has been doing for a dozen years,” O’Connor wrote. “Dr. Cannard was chosen for this responsibility not because he is a movement disorder specialist, but because he is a highly trained and highly regarded neurologist here at Walter Reed [National Military Medial Center] and across the Military Health System, with a very wide expertise which makes him flexible to see a variety of patients and problems.”

The questions about Biden’s health come after a poor debate performance that left people, including some Democratic lawmakers, questioning whether the president should step aside and allow someone else to run.

Biden has resisted those calls and on Monday repeated that he will stay in the race.