Federated Temporal Attention Intelligence for Cyber-Resilient IoMT: Lightweight Digital Twins and PPO-Driven Honeypot Deception

The rapid proliferation of IoT and IoMT devices introduces critical cybersecurity vulnerabilities in healthcare and industrial environments where resource-constrained devices operate under strict latency and data-privacy regulations. This paper presents the Federated Temporal Graph Convolutional Network with Advantage Actor-Critic (Federated TGCN-A2C), a privacy-preserving defense architecture integrating four mechanisms: a PyG-based Temporal GCN using GCNConv layers with global mean pooling and a learned anomaly gate for flow-level threat classification; LSTM-based Digital Twins generating per-device anomaly scores gating the classifier via learned sigmoid coupling; a Federated A2C agent selecting among ALLOW, ISOLATE, and HONEYPOT-REDIRECT actions based on a seven-dimensional state capturing confidence, entropy, anomaly magnitude, and traffic composition; and an enhanced honeypot layer converting suspicious traffic into threat intelligence with adaptive thresholds. Federated aggregation employs EMA-smoothed per-client validation losses as inverse-weighted FedAvg coefficients to stabilize global model updates under non-IID distributions, with cosine-annealed learning rates per round. Evaluated on CICDDoS 2019 and TON-IoT benchmarks, the framework achieves 99.48% and 99.61% test accuracy with weighted-F1 scores of 0.9948 and 0.9961, converging within 25 and 10 federated rounds, outperforming Fed-Inforce-Fusion by 0.21 percentage points while covering three additional attack categories. All sixteen CICDDoS 2019 classes achieve F1 of at least 0.9237 and all ten TON-IoT classes achieve F1 of at least 0.9488, including the severely imbalanced MITM category. Post-hoc explainability via SHAP, LIME, Grad-CAM, and counterfactual analysis confirms decisions are grounded in semantically meaningful flow features, supporting regulatory accountability in clinical deployments.

The rapid evolution of digital health technologies is redefining healthcare services worldwide. The integration of wireless communication and Internet-enabled medical devices within Internet of Medical Things (IoMT) networks enables continuous, real-time patient monitoring. However, this increased connectivity raises cybersecurity and patient safety risks due to increasingly sophisticated cyberattacks. This paper proposes a novel on-device, interpretable Tsetlin Machine (TM)-based Intrusion Detection System (IDS) to identify various phases of cyberattacks in IoMT environments. The TM is a rule-driven and transparent machine learning (ML) approach that represents attack patterns using propositional logic. Extensive evaluations on the MedSec-25 dataset, encompassing various phases of realistic cyberattacks, show that the proposed model outperforms ML models, attaining an F1-score (macro) of 97.83%. Moreover, the proposed model offers explicit explanations of its decisions to enhance transparency using feature-level contributions, class-wise vote scores, and clause activation heatmaps. Edge deployment (Raspberry Pi) further supports real-time on-device inference and intrusion detection. The combination of interpretability and high performance makes the proposed model well-suited for IoMT healthcare, where trust, reliability, safety, and timely decision-making are critical.

Internet of Medical Things (IoMT) devices operate under strict resource constraints while handling highly sensitive health data, making security and privacy critical concerns. Federated learning (FL) further complicates this landscape, as model updates exchanged during training may unintentionally expose private medical information. Emerging quantum computing capabilities threaten the long-term viability of conventional lightweight cryptographic mechanisms, motivating the integration of Post-Quantum Cryptography (PQC) into IoMT systems. This article discusses key enabling technologies for quantum-resilient IoMT, including post-quantum key establishment, lightweight encryption, and edge-native orchestration. We propose a scalable Kubernetes-based framework that integrates PQC into FL-enabled IoMT environments and validate it on a Raspberry Pi testbed. Results demonstrate that distributed cryptographic processing significantly reduces latency compared to sequential designs while maintaining feasible resource overhead. The primary contribution of this work lies in the design and validation of a secure orchestration and communication framework for FL-enabled IoMT systems. We conclude by outlining future directions toward energy-aware architectures, intelligent security optimization, and resilient next-generation Intelligent Internet of Medical Things (IIoMT) ecosystems.