Recovery of human compound action potential using a paired-click stimulation paradigm.

The recovery process from adaptation of the compound action potential (CAP) was studied using an equilevel paired click stimulation paradigm in humans with normal hearing. The CAP amplitude to the second click of paired clicks was normalized to the amplitude to the first click. The second-click CAP amplitude recovered as a function of interclick interval (ICI) between the first and the second click of a pair. A regression line fitted to the recovered amplitude data demonstrated the logarithmic function of the ICI. Full recovery times changed from 118 to 278 ms with increasing click intensity. The regression lines for higher click intensities exhibited two different slopes in two ICI ranges: from 3 to 100 and 120 to 300 ms. We suppose that the CAP recovery for ICI <100 ms is attributable to both the relative refractoriness of auditory nerve and the short-term adaptation mechanisms, while, for ICI >100 ms chiefly to the short-term adaptation mechanisms. The recovery process of the second-click CAP slowed with increasing intensity, which is a similar result to that obtained in the animal experiments by Parham et al. The input-output (I-O) curve of the second-click CAP amplitudes exhibited a different slopes above and below 60 dB normal hearing level (nHL). We assume that the mechanisms underlying this characteristic curve pattern differ from those for the I-O curve of the CAP in response to single-click stimuli. We expect that investigating the CAP recovery in pathological ears will provide clinically useful information on cochlear synaptic function.