BEFORE THE INJURY: STRUCTURAL REORGANISATION CAPACITY AND THE ARCHITECTURE OF STROKE RECOVERY The DMGE vs SRCT Named Binary in Stroke Outcome Science

Structured Abstract Background Stroke is the world's second leading cause of death and the leading cause of acquired adult disability. The dominant explanatory framework — Damage-Magnitude-Governs-Escape (DMGE) — holds that recovery is primarily determined by lesion volume, location, and tract overlap. Despite decades of refinement, damage-side models leave substantial variance in outcome unexplained, and fundamental anomalies persist: patients with identical lesion burden diverge systematically; the proportional recovery regularity breaks at the individual level; and contralateral network topology at baseline adds independent predictive power over ipsilesional damage measures in prospective outcome models. Gap The tradition has no account of the pre-stroke brain's structural capacity to reorganise function around the destroyed substrate — a property architecturally encoded before injury that operates as an incrementally significant transfer function between damage input and recovery output. This structural silence is not a quantitative inadequacy but a different explanatory level that no combination of damage-side variables can reach. Approach We introduce the Structural Reorganisation Capacity Transfer (SRCT) framework, which identifies the pre-stroke connectome's Topological Redundancy Index (TRI) as an independently significant determinant of post-stroke recovery ceiling, accounting for substantial residual variance after damage-side variables. We derive the Named Binary DMGE vs SRCT, specify a pre-registerable Collapse Counter-Scenario using prospective pre-stroke MRI cohorts and a synthetic TRI estimation pathway for the general population, confirm structural invariance across four independent domains, and derive the IGT Monitoring Principle with the f_min formula for rehabilitation scheduling. Results SRCT resolves three anomalies that DMGE cannot: the lesion-outcome dissociation, the proportional recovery paradox, and the contralateral topology predictor. Cross-domain invariance is confirmed in ecology, materials science, network engineering, and immunology. The CCS specifies falsification conditions testable in existing cohorts with pre-stroke neuroimaging, with power sensitivity analyses across reliability scenarios. A synthetic TRI estimation model extends the framework's clinical admissibility beyond biobank populations. Implications If confirmed, SRCT adds an architecturally prior explanatory level to stroke rehabilitation, enabling SRC-stratified rather than universally dosed intervention, reframing secondary prevention to include connectome resilience targets, and explaining replication failures in rehabilitation RCTs as structural confounding by SRC heterogeneity. Weil Protocol status: INCOMPLETE — L3 clinical review required before submission. Keywords: DMGE, SRCT, stroke recovery, structural reorganisation capacity, topological redundancy index, connectome, ischaemic stroke, rehabilitation stratification, proportional recovery, ALGUILAS-AI, Internal-Geometry Threshold, pre-stroke neuroimaging, synthetic TRI estimation, brain reserve Method ALGUILAS-AI Dialectical Engine