Decoding the Solution for Man-at-the-End Attacks and Reverse Engineering on IoMT Devices: An Experimental Review of...

Area of Science:

• Cybersecurity
• Medical Device Security
• Internet of Medical Things (IoMT)

Background:

• The Internet of Medical Things (IoMT) is transforming healthcare with remote monitoring and treatment capabilities.
• Physical access to IoMT devices enables Man-At-The-End (MATE) attacks, compromising sensitive data and patient safety.
• Current software solutions offer insufficient protection against physical access threats.

Purpose of the Study:

• To analyze the vulnerability of IoMT devices to MATE attacks.
• To evaluate the effectiveness of Physically Unclonable Functions (PUF) and Field Programmable Gate Arrays (FPGA) in mitigating these threats.
• To propose futuristic security enhancements for IoMT devices.

Main Methods:

• Classification of critical MATE attacks specific to IoMT devices.
• Experimental validation using Arduino Uno, Raspberry Pi, and ESP32 for reverse engineering.
• Review of existing security measures and comparison with PUF/FPGA-based solutions.

Main Results:

• MATE attacks pose a significant risk to IoMT devices, leading to misdiagnosis and patient harm.
• PUF and FPGA-based security offer robust authentication, real-time processing, and obfuscation against MATE attacks.
• Analysis reveals vulnerabilities in PUF-enabled IoMT devices against specific MATE attack vectors.

Conclusions:

• PUF/FPGA-based security presents a promising approach to enhance IoMT device resilience against MATE attacks.
• Further research into tamper-proof hardware, evolvable PUF, and AI-assisted anomaly detection is crucial for future IoMT security.
• This study provides practical insights into securing IoMT devices against sophisticated cyber threats.