Professor Alexandra J. Sinclair MBChB, FRCP, PhD

Professor Alex Sinclair

Department of Metabolism and Systems Science
Professor of Neurology, Bloomer Chair of Neurology

Contact details

Address
Translational Brain Science Research Group
Department of Metabolism and Systems Science
College of Medicine and Health
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Professor Sinclair is Professor of Neurology within the Department of Metabolism and Systems Science at the University of Birmingham, and Head of the Translational Brain Science Research Group. She is an international figure in translational research in Idiopathic Intracranial Hypertension (IIH), headache and traumatic brain injury.

Her research portfolio encompasses in vitro and in vitro studies coupled with a clinical trials program and biomarker evaluation. The research is closely linked with the headache service at University Hospital NHS Foundation Trust, UK where she works as a consultant neurologist. Professor Sinclair is currently leading two clinical trials in IIH. 1) The IIH Intervention trial, which compares CSF shunting with venous sinus stenting to preserve vision. 2) The IIH Advance trial which will evaluate the role of weight loss driven by the anti-obesity medication Tirzepatide (Mounjaro) to treat IIH.

She is the chair for the British Association for the Study of Headache (BASH), the UK headache society. She has been a board member of the International Headache Society (IHS) and European Headache Federation, was on the scientific committee for the North American Neuro-Ophthalmology Society (NANOS) and  was the Deputy Chair for the Association for British Neurologists grouping for Headache and Pain (ABN AAG). She was on the research committee for the Association for British Neurologists and was also the previous patron of the patient charity IIH UK. Professor Sinclair was previously on the MRC Neuroscience and Mental Health Board and the Midland Neuroscience Teaching and Research Fund Board, as well as the Brain Research UK Scientific Advisory Board.

Professor Sinclair consults for  the National Aeronautics and Space Administration (NASA) to focus on advancing understanding of Spaceflight Associated Neuro-ocular Syndrome (SANS), a condition affecting astronauts’ brains and vision during long-duration spaceflight.

The research compares SANS with a similar Earth-based condition, Idiopathic Intracranial Hypertension (IIH), to better understand how fluid shifts and elevated intracranial pressure impacts the brain, eye and optic nerve in both microgravity and terrestrial environments.

Professor Sinclair’s  work draws on extensive clinical expertise in IIH to identify shared mechanisms and inform guidelines for  treatment pathways for SANS. A key area of investigation is whether the GLP-1 receptor agonists exenatide, shown to reduce intracranial pressure in IIH, could be developed as a countermeasure to protect astronaut vision on extended space missions.

 

Clinical trials

Clinical trials are changing, and we are leading the way here at Birmingham. Traditional trials often struggle to recruit patients who truly represent the condition being studied.

Professor Alex Sinclair, Professor of Neurology at the University of Birmingham, is pioneering a decentralised approach for the IIH Advance Trial, focused on idiopathic intracranial hypertension (IIH) - a debilitating neurological disorder that causes raised intracranial pressure resulting in severe headaches and swelling of the optic nerve.

The trial is exploring the potential of GLP‑1 treatments to transform outcomes for people living with IIH. Participants can self‑refer via social media, medication is delivered directly to their homes, and follow-up appointments take place via video consultation. Specialist ‘optical coherence tomography’ scans are carried out at local high‑street opticians. Taking clinical trials into the community.

Over the period of 10 years, Professor Sinclair has published her work extensively and has also been awarded over £22million in grant funding in relation to her research from organisations such as, but not limited to, the Medical Research Council, National Institute for Health and Care Research (NIHR), The Sir Jules Thorn Charitable Trust,  Department of Defence USA, the Ministry of Defence UK and the UK Space Agency.

Qualifications

  • Member by Distinction of the Faculty of Pharmaceutical Medicine, 2024
  • Institute of Directors (Role of Directors and the Board), 2020
  • Fellow of the Royal College of Physicians, 2019
  • Neurology Consultant, (Registration in Neurology with the GMC), 2012
  • PhD, 2010
  • Member of the Royal College of Physicians (MRCP), UK, 2003
  • MBChB, University of Birmingham, 2000

Biography

NASA delegation visits University of Birmingham to discuss its mission to Mars

Professor Sinclair graduated from the University of Birmingham's Medical School in 2000 with honours and attained her MRCP in 2003. She completed her PhD in 2010, funded by a Medical Research Council Clinical Research Training Fellowship. Subsequently, she worked as a National Institute for Health Research (NIHR) Clinical Lecturer in Neurology and then a NIHR funded Clinician Scientist & Neurology Consultant.

She leads a translational research group, which seeks to establish and exploit the pathophysiological mechanisms underpinning the debilitating effects of metabolism and intracranial pressure on headache, traumatic brain injury and Idiopathic Intracranial Hypertension (IIH). She looks to develop therapeutic strategies and generate real impact while improving patient care. The translational portfolio also encompasses a clinical trials programme enabling forward (novel therapeutic molecules are under assessment in patients) and back translation (biomarker evaluation in the laboratory setting).

Professor Sinclair is the chair for the British Association for the Study of Headache (BASH), the UK headache society. She has been a board member of the International Headache Society (IHS) and   European Headache Federation, was on the scientific committee for the North American Neuro-Ophthalmology Society (NANOS) and  was the Deputy Chair for the Association for British Neurologists grouping for Headache and Pain (ABN AAG). She was on the research committee for the Association for British Neurologists and was also the previous patron of the patient charity IIH UK. Professor Sinclair is on the MRC Neuroscience and Mental Health Board and the Midland Neuroscience Teaching and Research Fund Board, as well as the Brain Research UK Scientific Advisory Board.

Professor Alexandra Sinclair and her Translational Brain Science Research Group at the University of Birmingham are collaborating with NASA to advance understanding of Spaceflight Associated Neuro-ocular Syndrome (SANS), a condition caused by prolonged exposure to microgravity that leads to raised intracranial pressure and vision problems in astronauts.

Building on Professor Sinclair’s internationally recognised work in Idiopathic Intracranial Hypertension (IIH), the collaboration compares clinical data from both conditions to better understand how increased brain pressure affects the eye and optic nerve on Earth and in space.

A major focus is the team’s discovery that GLP-1 receptor agonists can reduce intracranial pressure, now progressing through Phase 3 clinical trials. This research has potential to inform new treatments for IIH patients and develop protective countermeasures for astronauts on long-duration missions, including future travel to Mars.

Professor Sinclair and her research group hosted a high profile visit from NASA in 2019 and 2026 which invited Dr J.D Polk, Chief Health and Medical Officer, Dr Terrance Taddeo, Johnson Space Centre Chief Medical Officer, Dr Mike Barratt, Physician and Astronaut, Dr Victor Schneider, Physician Liaison to the NASA Human Research Programme and Dr John Allen, Audiologist and member of the Human Exploration to the University of Birmingham to discuss the novel use of glucogon-like peptide 1 receptor agonists to reduce intracranial pressure.


The team hosted another visit from NASA in 2026 which invited NASA's Chief Health and Medical Officer, Dr J.D. Polk, alongside clinical and research colleagues focused on managing and treating Space Flight Neuro-ocular Syndrome (SANS) in astronauts. The delegation discussed SANS which is caused by chronic exposure to microgravity and leads to intracranial pressure and optic nerve swelling, resulting in significant visual problems for astronauts and the similarities of Idiopathic Intracranial Hypertension (IIH). 

Professor Sinclair founded and was Chief Investigator of the mTBI-Predict study (2020 – 2025) in partnership with the Ministry of Defence (UK) and Department of Defence (US) aimed at identifying new ways to accurately predict whether patients will develop long-term complications as a consequence of mild Traumatic Brain injury.

Professor Alex Sinclair awarded Membership by Distinction of Faculty of Pharmaceutical Medicine.

Professor Alex Sinclair, (left), and Dr Felicity Gabbay, FPM President (right)

Professor Alex Sinclair was awarded Membership by Distinction of Faculty of Pharmaceutical Medicine. Recognised internationally for her pioneering research in headache and brain trauma, Professor Sinclair, Professor of Neurology at the University of Birmingham, has been involved in the identification of disease pathways, discovering new drug approaches that act on these pathways and subsequently evaluating these drug approaches in clinical studies to assess their usefulness in treating patients.

Clinical

Professor Sinclair completed her Certificate of Specialist Training in Neurology in 2013 and established and previously led the Complex Headache Service at University Hospital Birmingham. She is a keen advocate and supporter of the multi-disciplinary care approach for Idiopathic intracranial hypertension and traumatic brain injury run at University Hospital Birmingham. She has a particular interest in traumatic brain injury and post-traumatic headache. She is passionate about driving excellence in clinical care and moving knowledge from research to improved patient outcomes.

Professor Sinclair is leading a trial for a debilitating neurological condition by recruiting patients directly online, with postal medication, and high-street eye scans, relieving NHS bottlenecks and giving patients control. IIH Advance trial.

Teaching

Teaching Programmes

Research

Professor Sinclair's work is supported by a number of academic grants and collaborations with industry.

Defining new treatment and headache mechanisms in raised intracranial pressure

Through a Sir Jules Thorn Award for Biomedical Science, Professor Sinclair is running a 5-year programme defining new treatment and headache mechanisms in raised intracranial pressure. A previous small clinical trial and shown efficacy for the GLP-1 receptor agonist exenatide to treat idiopathic intracranial Inhypertension. In this research program she will be evaluating the efficacy of a GLP-1 receptor agonist to treat Idiopathic Intracranial Hypertension (IIH) through a large UK randomised control trial. Mechanistic work will comprise human physiology studies with complimentary in vivo studies. 

Establishing the optimal surgical intervention to preserve vision in IIH

This UK multi-centre randomised control trial funded by the NIHR HTA for six years will evaluate the effectiveness and cost effectiveness of dual venous sinus stenting compared to cerebrospinal fluid shunting to prevent visual loss in fulminant IIH. The trial is called IIH: Intervention and is a UK wide multicentre-trial.

Defining the metabolic contributors to intracranial pressure regulation

Utilising in vivo models with intracranial pressure monitoring, the group is exploring mechanisms that regulate intracranial pressure. 

Establishing accurate biomarkers for mild traumatic brain injury

Funded by the US Department of Defence and UK Ministry of Defence (total funds > £15.5M)  in collaboration with the Royal Centre of Defence Medicine, this study is seeking to identify accurate reproducible biomarkers in mild traumatic brain injury (mTBI) that will predict the most common and disabling consequences of mTBI: primarily persistent post-traumatic headache, as well as cognitive dysfunction, depression, PTSD, dizziness and return to work. This will be achieved through an interdisciplinary harmonised research programme consisting of detailed clinical phenotyping of acute mTBI patients coupled with state-of-the-art multimodal biomarker evaluation (brain imaging, fluid biomarkers, steroid hormones, visual, vestibular, cerebral physiology and EEG biomarkers) in both military and civilian patients. The study will run over 8 years and is called mTBI Predict.


Investigate the optimal method of therapeutic weight management in IIH

Through a five year research programme funded by the NIHR, a randomised control trial (IIH:WT) has previously evaluated the optimal method of treating IIH through weight loss by comparing a bariatric surgery pathway with a community weight loss interventionas well as evaluating how much weight loss is needed. The programme additionally seeks to identify the relationship between weight and intracranial pressure and headache. As well as gaining understanding of the mechanisms by which weight loss modifies intracranial pressure.

Laboratory science to evaluate mechanism and novel therapeutics in headache and traumatic brain injury

The Translational Brain Science Preclinical Laboratory Team spans from  in vivo to in vitro laboratory research and  aims to understand and treat neurological conditions associated with headache, raised intracranial pressure and traumatic brain injury.

Use of GLP1-RA to Prevent SANS during Bed Rest

Funded by NASA, this research will advance the understanding of Spaceflight‑Associated Neuro‑ocular Syndrome (SANS) and compare data with a similar clinical entity that occurs on the ground, known as Idiopathic Intracranial Hypertension. A key focus of the collaboration includes exploring whether GLP‑1 receptor agonists, which have shown the ability to lower intracranial pressure in IIH, could become a viable countermeasure to protect astronaut vision on long‑duration missions.

Current Clinical Trials

Other activities

Membership of professional bodies

Public engagement

  • Previously Patron of charity Idiopathic Intracranial Hypertension (IIH) UK (producing patient information leaflets, information videos and dissemination of clinically relevant information research through the annual patient conference). 

Patents and commercialisation

  • Patent: Inventor for the use of GLP-1 agonists in intracranial pressure, no: 1415598 (filed 2014 US, EU, ROW: granted 2019 ROW 2020 EU & US)
  • Orphan Drug designation: European Medicine Agency and FDA 2016.
  • Spin out company: Invex Therapeutics, Founder, Previous Executive Director and Chief Scientific Officer (formed 2018 and listed on the Australian Stock exchange following capital raises of AUS $38).

Publications

Recent publications

Article

Ruwan Wanni Arachchige, P, Gao, Y, Idrees, I, Fildes, J, Finch, A, Hawa, W, Craig, M, Brookes, MJ, Hill, LJ, Lucas, SJE, Mitchell, JL, Sinclair, AJ, Novak, J, Bagshaw, AP, Wilson, M, Fernandez-Espejo, D, Mullinger, KJ & UK mTBI Predict Consortium 2026, 'Assessing optimisation of 3T MRI protocol across multi-site, multi-vendor settings for studying mild Traumatic Brain Injury: mTBI Predict Consortium study', Aperture Neuro, vol. 6. https://doi.org/10.52294/001c.157692

Yiangou, A, Phu Do, T, Mollan, SP, Thaller, M, Mitchell, JL, Mugo, CW, Tsermoulas, G, Hill, LJ, Lucas, SJE, Ashina, M & Sinclair, AJ 2026, 'Calcitonin gene-related peptide induces headache attacks in people with idiopathic intracranial hypertension', Brain. https://doi.org/10.1093/brain/awag126

Tsermoulas, G, Mollan, SP, Homer, V, Kristunas, C, White, P, Wakerley, BR, Toma, AK, Robertson, F, Berman, G, Ahmed, F, Atan, D, Bandyopadhyay, S, Barton, D, Booth, T, Bremner, F, Denton, A, Downer, J, Edwards, R, Frew, E, Gew, J, Hill, L, Hughes, T, Lax, S, Macdonald, J, Maxwell, G, McHugh, J, Shah, P, Taleti, E, Tasker, R, Thomas, S, Joannides, AJ & Sinclair, A 2026, 'Cerebrospinal fluid shunting or dural venous sinus stenting to preserve vision in idiopathic intracranial hypertension (IIH Intervention): Protocol for an open-label, multicentre, randomised controlled phase IIb trial', BMJ Open.

Yiangou, A, Phu Do, T, Grech, O, Mugo, CW, Thomas, CN, Gew, J, Lange, MG, Gee, M, Mollan, SP, Hill, LJ, Lucas, SJE, Ashina, M & Sinclair, AJ 2026, 'CGRP-provoked headache is associated with a neuroimmune signature in idiopathic intracranial hypertension', The Journal of Headache and Pain, vol. 27, no. 1, 159. https://doi.org/10.1186/s10194-026-02385-0

Hill, LJ, Begum, G, Thomas, CN, Hubbard, JC, Mugo, C, Alimajstorovic, Z, Botfield, HF, Lyons, HS, Thaller, M, Yiangou, A, Ludwig, C, Grech, O, Mitchell, JL, Mollan, SP & Sinclair, AJ 2026, 'Identifying MicroRNA Biomarkers in Idiopathic Intracranial Hypertension: A Pilot Study', Neurology, vol. 107, no. 1, e218162. https://doi.org/10.1212/WNL.0000000000218162

Goadsby, PJ, Sinclair, AJ, Afridi, SK, Lucas, C, Mawet, J, Lanteri-Minet, M, Moisset, X, Diener, HC, Gaul, C, Jürgens, TP, Sumelahti, ML, Sanchez Del Rio, M, Pozo-Rosich, PD, Russo, A & Barbanti, P 2026, 'Moderate to Severe Acute Migraine Attacks: An Opinion Paper on the Use of Triptans and Triptan-NSAIDs Combinations in Individualized Treatment Plans', Neurology and Therapy, vol. 15, pp. 15-28. https://doi.org/10.1007/s40120-025-00874-z

Lange, MG, Vickers, A, Hill, LJ, Mollan, SP, Mitchell, J, Sinclair, AJ & Lee, AG 2026, 'Pro-Con: Antiobesity Drugs Such as Glucagon-Like Peptide-1 Receptor Agonists Should Be a First-Line Treatment in Idiopathic Intracranial Hypertension', Journal of Neuro-Ophthalmology, vol. 46, no. 1, pp. 117-127. https://doi.org/10.1097/WNO.0000000000002431

Tsermoulas, G, Mollan, SP & Sinclair, A 2026, 'Reconceptualizing intracranial pressure: the role of amplitude in comprehensive reporting', JNS - Journal of Neurosurgery. https://doi.org/10.3171/2025.9.JNS251551

Grech, O, Mugo, W, Hill, LJ, Heaselgrave, SR, Alimajstorovic, Z, Yiangou, A, Lyons, HS, Mitchell, J, Lavery, GG, Fulton, D & Sinclair, AJ 2026, 'The metabolic consequences of evoked spreading depolarization in brain slices', Scientific Reports. https://doi.org/10.1038/s41598-026-37175-w

Comment/debate

Tsermoulas, G, Gikas, N, Sinclair, AJ, Mollan, SP & Berman, G 2026, 'Comment on “Surgical versus endovascular treatment for idiopathic intracranial hypertension”', Neurochirurgie, vol. 72, no. 1, 101754. https://doi.org/10.1016/j.neuchi.2025.101754

Gew, J, Berman, G, Sinclair, A & Mollan, S 2026, 'Enhancing comparability in idiopathic intracranial hypertension research through standardised outcome measures: In reply to: Outcomes of venous sinus stenting versus ventriculoperitoneal shunting for fulminant idiopathic intracranial hypertension: a dual-center analysis', Neurosurgical Focus.

Tsermoulas, G, Mollan, SP & Sinclair, AJ 2026, 'Response: Reporting of Intracranial Pressure Amplitude', JNS - Journal of Neurosurgery.

Review article

Lyons, HS, Hubbard, JC, Thomas, CN, Roberts, JA, Mugo, CW, Bellamy Plaice, G, Grech, O, Prosser, S, Strom, A, Lucas, SJE, Downie, LE, Gill, JM, Mitchell, JL, Sinclair, AJ, Hill, LJ & UK mTBI Predict Consortium 2026, 'Biofluid-based predictors of post-concussion symptoms: a narrative review of mild traumatic brain injury biomarkers', Brain Communications, vol. 8, no. 1, fcaf501. https://doi.org/10.1093/braincomms/fcaf501

Kennedy, G, Watson, DPB, Davies, B, Bahra, A, Fisher, C, Ghadiri-Sani, M, Kamourieh, S, Gew, JJY, Long, M, Weatherall, M, Wakerley, B, Anderson, JM & Sinclair, AJ 2026, 'Migraine-advanced preventative treatments: the British Association for the Study of Headache Clinical Practice Recommendations and Consensus Guidance ', Journal of Neurology Neurosurgery and Psychiatry. https://doi.org/10.1136/jnnp-2026-339062

Gew, J, Hyder, YF, Grech, O, Brunstetter, T, Tarver, W, Mason, SS, Gibson, CR, Polk, JD, Schneider, VS, van Baalen, M, Mitchell, JL, Yiangou, A, Mollan, SP & Sinclair, AJ 2026, 'Spaceflight-associated neuro-ocular syndrome (SANS): expert consensus on diagnosis and management', Eye. https://doi.org/10.1038/s41433-026-04651-6

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