Mayo Clinic, which serves ~1.3M patients annually, has a history of excellence in clinical research and clinical trials. Its state-of-the-art research facilities in Rochester, Minnesota, Jacksonville, Florida, and Scottsdale, Arizona enable coordinated clinical trials in the upper Midwest, Southeast, and Southwest United States. The Department of Neurology, which has over 200 child and adult neurologists, has an enterprise-wide leadership structure that supports its integrated practice, research, and education mission. Mayo Clinic Neurology cares for >90,000 adult and pediatric patients annually and has a robust clinical research enterprise. Departmental faculty have clinical expertise and clinical trial experience across the full spectrum of neurological diseases, including rare and ultra-rare conditions. Mayo Clinic is ideally positioned to provide NeuroNEXT the diverse patients with unmet needs and the clinical trialists with expertise in these diseases. Investigator-initiated clinical trials by Mayo neurology faculty will be directed towards NeuroNEXT funding mechanisms. This grant application aims to support, expand, and innovate neuroscience clinical trial activities at all Mayo Clinic sites by providing the infrastructure to ensure robust integration within NeuroNEXT, while leveraging our institutional strengths. Furthermore, the grant will support an innovative program to train the next generation of clinical trialists to thrive in an evolving landscape of innovative trial design and modern regulatory science.